城乡居民医疗保险体系“亲贫”减贫效果分析--基于19308份报销病例

Analysis on the Poverty Reduction Effect of“Pro-poor”Policy of Medical Insurance System for Urban and Rural Residents--Based on 19308 Cases

医疗保险的“亲贫”减贫作用,一方面通过减少患者自付费用、降低灾难性医疗支出发生率得以实现,另一方面通过有针对性的“亲贫”政策进行修正强化。文章基于2020年度新疆兵团A师19308例城乡居民医疗保险参保人员报销病例,用Probit模型、多元逐步回归模型分析城乡居民医疗保险体系“亲贫”减贫效果。结果表明:城乡居民医疗体系可使患者自付费用下降66.04%、灾难性医疗支出发生率下降10.43%,减贫效果明显;贫困患者的自付费用百分率比普通患者降低14.95%~16.46%,灾难性医疗支出发生率降幅比普通患者大23.48%,纵向“亲贫”效果明显;贫困患者更易发生灾难性医疗支出。建议加强本地医疗机构综合建设、将更多自费药纳入统筹、加大民政救助的力度。

The poverty reduction effect of medical insurance is realized through the horizontal financial transfer between the health insured group and the patients.On the one hand,this can be achieved by reducing residents’own expenses and reducing the inci⁃dence of catastrophic medical expenses.On the other hand,it can be corrected and strengthened by targeted“pro-poor”policy.Based on 19308 medical insurance reimbursement cases of urban and rural residents from A regiment of XPCC in 2020,this paper analyzes the poverty reduction effect of“pro-poor”policy of medical insurance system for urban and rural residents with Probit model and multiple stepwise model.The results show that the expenses of patients decrease by 66.04%and the incidence of CHE by 10.42%,which shows an obvious poverty reduction effect.The percentage of poor patients’s expenses of decreases by 14.95%~16.46%compared to that of ordinary patients,and the incidence of CHE is 23.48%higher than that of ordinary patients,which shows an obvious longitudinal“pro-poor”effect.Poor patients are more prone to catastrophic health costs.It is suggested to strengthen the comprehensive construction of local medical institutions,bring more self-financed drugs into the overall plan,and strengthen the efforts of civil affairs assistance.