我国大病保险政策评价:基于旬邑县的实证研究

Evaluation on the Catastrophic Medical Insurance Policy in China: Based on Empirical Research of Xunyi County

目的:采用公共政策分析方法对大病保险政策运行效果和政策实施现状进行评价。方法:采取国际上通行的"结构-过程-结果"评价体系,通过合理设定测量指标和评价方法,对大病保险制度设计、政府支持、基金运行状况等进行评价。结果:旬邑县大病保险制度体系已经较为完备,资金筹集和运行情况良好,有效降低了大病患者家庭灾难性卫生支出发生率,但也存在参保率不高、待遇水平较低等问题。结论:应通过拓展筹资渠道、开发商业医疗保险等措施进一步提高大病保险的保障水平和扩大受益范围,建立大病保险运行的科学评价系统。

Objective:Public policy analysis method was used to evaluate the policy running effects and the current implementation situation of the catastrophic medical insurance.Methods:Based on the general international evaluation system of 'structure-process-outcome', reasonable sets of metrics and measurement methods were designed to evaluate the system design, government support and fund operating conditions of catastrophic medical insurance.Results:Catastrophic medical insurance mechanism of Xunyi County was relatively completed, fund raising and running were in good condition, which effectively reduced the incidence of catastrophic health expenditure, but the enrolment rate of the employees and the treatment level still needed to be improved.Conclusion:It needed to expand the financing channel and develop commercial medical insurance so as to further develop the insurance level, expand the benefit range of the catastrophic medical insurance mechanism and establish a scientific evaluation system for the operation of catastrophic medical insurance.