东部某省城乡居民基本医疗保险的住院补偿公平性研究

Research on the Fairness of Hospitalization Compensation for Basic Medical Insurance for Urban and Rural Residents in an Eastern Province

目的分析医疗保险住院补偿受益人群的公平性,为调整和设计城乡居民医保提供参考依据。方法利用东部某省卫生服务调查数据,采用多阶段抽样的方法抽取调查对象,用集中指数(concentration index,CI)及其分解法来分析各因素对补偿费用的贡献,采用多元线性回归分析补偿费用相关影响因素。结果不同经济收入组在一年内住院补偿费用的公平性分析中,集中指数CI=0.064。多元线性回归分析表明在其他条件一定的情况下,住院天数越多以及在住院期间接受手术的参保人群会得到较高的补偿。集中指数分解法表明初中及以上的文化程度对补偿费用不公平的贡献最大。结论东部某省城乡居民基本医疗保险的住院补偿存在不公平性。

Objective To analyze the fairness of the beneficiaries of inpatient compensation in medical insurance,and to provide reference for the adjustment and design of medical insurance for urban and rural residents.Methods Based on the survey data of health services in a eastern province,the research objects were selected by multi-stage sampling method.The contribution of each factor to the compensation cost was analyzed by the concentration index(CI)and its decomposition method,and the related factors of compensation cost were analyzed by multiple linear regression.Results In the fairness analysis of hospitalization compensation expenses of different economic income groups within one year,CI=0.064.Multiple linear regression analysis showed that under certain other conditions,the more days in hospital,the higher compensation for the insured population who had surgery during hospitalization.The centralized index decomposition method shows that the education level of junior high school and above contributes the most to the unfair compensation cost.Conclusion There is inequity in hospitalization compensation for basic medical insurance for urban and rural residents in an eastern province.