基于健康扶贫经验证据的医疗支出集中性研究

Research on the Concentration of Medical Expenditure Based on the Empirical Evidence from Health Poverty Alleviation

目的:研究贫困人口的医疗支出集中性问题,丰富医疗支出集中性的经验证据,为控制合理医药费用和巩固拓展健康扶贫成果提供决策参考。方法:基于全国健康扶贫动态管理系统数据,用描述统计、洛伦兹曲线、基尼系数和百分位数份额法分析医疗支出集中性以及高医疗支出群体的特征。结果:少部分高医疗支出群体花费了大部分医疗支出,前10%医疗支出占总支出的比重超过了 55%;高医疗支出群体具有典型的特征,具体表现为男性多、高龄化、残疾化、县域外就诊和住院比例高、大病患者多。结论:贫困人口的医疗支出也表现出很强的集中性,应根据高医疗支出群体特征和人口结构演变,建立和完善多层次医疗保障体系,完善面向全人群的大病重病保险政策。

Objective:To study the concentration of medical expenditure of the poor,enrich the empirical evidence of the concentration of medical expenditure,and provide decision-making references for controlling reasonable medical expenses and consolidating and expanding the achievements of health poverty alleviation.Methods:Based on the data of the national health poverty alleviation dynamic management system,the descriptive statistics,Lorenz curve,Gini coefficient and percentile share method are applied to analyze the concentration of medical expenditure and the characteristics of high medical expenditure groups.Results:A small number of high medical expenditure groups spend most of the medical expenditure,and the top 10% of the medical expenditure accounts for more than 55% of the total expenditure.High medical expenditure groups have typical characteristics,such as more male,aging,disability,high proportion of medical treatment and hospitalization outside the county,and more serious patients.Conclusion:According to the characteristics of high medical expenditure group and the evolution of population structure,it needed to establish and improve the multi-level medical security system,and improve the serious illness insurance policy for the whole population.