陕西省某贫困县大病专项救治减贫效果分析

Analysis on poverty alleviation effectiveness by the catastrophic disease assistance of a poverty county in Shaanxi Province

目的通过测算贫困人口大病专项救治下患者医疗费用及保障情况,了解大病专项救治政策的减贫效果。方法基于陕西省某贫困县医保数据库、建档立卡贫困户数据库,收集该县大病专项救治对象医疗费用支出数据,使用贫困发生率、贫困缺口率、加权贫困缺口率、灾难性卫生支出发生率与平均差距测算大病专项救治“四重保障”的减贫效果。结果医疗救助后,该贫困县大病专项救治患者灾难性卫生支出发生率降低了7.41%,灾难性卫生支出平均差距降低了3.67%。“四重医疗保障”补偿后,贫困发生率降低了31.11%,贫困缺口减少了36.99万元,贫困缺口率减小89.83%,加权贫困缺口率减小820.85%。结论大病专项救治“四重保障”有效缓解了“因病致贫”问题,但仍存在部分病种医疗费用负担较重的问题,因此要加强医保政策的动态调整,提高大病集中救治政策的精准性,有效提升大病患者抵御灾难性卫生支出的能力。

Objective To learn the poverty alleviation effectiveness of the catastrophic disease assistance by measuring the medical expenses and security of patients under the catastrophic disease assistance of the poor.Methods Based on the medical insurance database of a poor county in Shaanxi province and the database of registered poor households,the medical expenditure data of the objects of special treatment for serious diseases in the county were collected,and the poverty alleviation effectiveness of the"four guarantees"of catastrophic disease assistance was calculated by using the incidence of poverty,poverty gap rate,weighted poverty gap rate,incidence and average gap of catastrophic health expenditure.Results After medical assistance,the incidence of catastrophic health expenditure for patients with serious diseases treated in the poor county decreased by 7.41%,the average gap of catastrophic health expenditure decreased by 3.67%.After the"four medical guarantees"compensation,the incidence of poverty reduced by 31.11%,the poverty gap reduced by 369900 yuan,the poverty gap rate reduced by 89.83%,and the weighted poverty gap rate reduced by 820.85%.Conclusion The"four guarantees"of catastrophic disease assistance effectively alleviate the problem of"poverty caused by illness",while there is still a heavy burden of medical expenses for some diseases.Therefore,it is necessary to strengthen the dynamic adjustment of medical insurance policy,improve the accuracy of medical insurance policy for centralized treatment of serious diseases,and effectively improve the ability of patients to resist catastrophic health expenditure.