2018年甘肃省城乡居民大病保险运行现状研究

Research on the Operation Status of Critical Illness Insurance for Urban and Rural Residents in Gansu Province in 2018

目的:分析2018年甘肃省城乡居民大病保险运行情况,总结该年度大病保险工作取得的成效和不足,为甘肃省进一步完善大病保险相关政策提供参考。方法:从甘肃省医疗保障局提取2018年度全省14个市(州)大病保险经办数据,进行描述性统计分析。结果:全省大病保险基金使用率为79.92%;大病患者大病保险平均报销比例为15.37%;住院患者次均自付住院费用占人均收入的比例为33.19%;贫困患者平均实际报销比例为76.22%。结论:甘肃省大病保险的实施有效提升了城乡居民整体保障水平,但仍存在基金使用率不高、部分大病患者住院费用个人负担较重、贫困患者整体保障水平不高等问题。

Objective:To analyze the operation of critical illness insurance for urban and rural residents in Gansu province in2018,summarize the achievements and deficiencies of critical illness insurance in 2018,and provide references for further improving relevant policies of critical illness insurance in Gansu Province.Methods:Extracted data from the Gansu Provincial Medical Security Bureau for the handling of critical illness insurance in 14 cities and prefectures of Gansu in 2018 were collected and performed by descriptive statistical analysis.Results:The utilization rate of the provincial critical disease insurance fund was 79.92%.The average reimbursement rate of critical illness insurance for patients with critical illness was 15.37%.The proportion of hospitalization expenses paid by inpatients per time as per capita income was 33.19%.The average actual reimbursement rate for poor patients was 76.22%.Conclusion:The implementation of critical disease insurance in Gansu had effectively improved the overall security level of urban and rural residents,but there were still some problems,such as low utilization rate of funds,heavy personal burden of hospitalization expenses for some critical ill patients,and low overall security level for poor patients.