城乡居民重大疾病医疗支出型贫困救助标准研究

A Research on the Standard of Catastrophic Illness Expenditure-based Poverty Relief for Urban and Rural Residents

救助标准作为影响重疾患者受助水平、救助基金的需求规模和可持续性的重要因素,是重疾救助制度发展的技术基础。本题以城乡居民大病保险数据库为基础,通过对大病保险和大病救助后的个人自付费用分布特征的讨论,对不同救助标准的救助绩效进行了对比分析。研究认为,在救助基金规模既定条件下,封顶线、救助比、分段按比例救助中救助比级差等技术标准的设计应建立在疾病医疗费用分布特征基础上,并以大病病种费用分布为基础,积极探索按病种救助的技术。

As an important factor influencing assistance level of patients with catastrophic illness,rescue fund demand scale and sustainable development,relief standard is an important technical basis for the development of serious illness relief system.Based on database of urban and rural residents illness insurance,effectiveness of different relief standard are compared through discussing the distribution of the individual pays of critical patients that are paid by illness insurance and serious illness relief.Research suggests that the design and priority selection of relief technical standards such as cap line,relief ratio and difference of relief ratio according to the proportion of relief section,should be based on the distribution of medical expenses,when the rescue fund scale is established.It is important exploring the technical assistance according to distribution of the critical disease costs.