农村因病贫困的医疗救助减贫成效分析

Analysis on poverty reduction effectiveness by medical relief for poverty-stricken rural population incurred by illness

目的通过测算各类医疗救助标准及模拟自费补偿下的减贫成效，了解农村因病贫困人群医疗救助减贫效果。方法基于“国家扶贫改革试验区”浙江省丽水市莲都区2016年度医疗救助对象的医疗费用支出明细数据，测算其医疗实际自付费用及救助比例。数据采用描述性分析。结果医疗救助介入后，有458人的实际自付费用降至2．2万元贫困线以下，30．25％的人群走出困境。不同的医疗救助方案组合，在各费用区间的减贫成效不同。结论因病贫困人群医疗救助标准合理化选择，需要以医疗实际自付费用分布规律为参考，确定救助目标；探索医疗自费部分救助，引入商业保险补充救助资金；根据救助资金需求及供给态势，选择适宜的救助技术。

Objective By measuring various medical relief standards and simulating the poverty reduction outcomes for compensation for self-paid expenses, to learn the outcomes of medical on poverty reduction in rural areas. Methods Using the detailed medical expenditure of those subject to medical relief in 2016 in Liandu district of Lishui city of Zhejiang province, we calculated their self-paid medical expenses and the proportion of medical relief. The data were analyzed by descriptive analysis. Results Thanks to the medical relief, the self-paid expenses of 458 people fell to under 22 000 yuan, i. e. the poverty line, and 30. 25% of them overcame poverty. It was found that different medical relief schemes score different poverty reduction effects among various expense sections. Conclusions Rational choices of medical relief standards for such population call for reference of the distribution pattern of their specific self-paid medical expenses, a benchmark to identify those in need of assistance. Attempts are needed to explore partial assistance for selfpaid medical expenses and introduce commercial insurance to make up for the assistance. It is recommended to select appropriate rescue means as required by the demand and supply of the rescue funds.