| 引用本文：李叶,吴群红,高力军.我国农村居民灾难性卫生支出的制度成因分析[J].中国卫生政策研究,2012,5(11):55-59 |
|
| 我国农村居民灾难性卫生支出的制度成因分析 |
| 投稿时间：2012-07-31 修订日期：2012-09-27 PDF全文浏览 HTML全文浏览 |
| 李叶1, 吴群红1, 高力军1 |
| 哈尔滨医科大学卫生管理学院 |
| 摘要:目的:中国农村人口的健康问题与中国社会的可持续发展密切相关。我国农村仍存在因病致贫、因病返贫现象。利用灾难性卫生支出率和致贫率作为测量工具，来衡量新型农村合作医疗的保障力度。方法：数据来源于第四次卫生服务调查，采用WHO推荐的方法计算灾难性卫生支出。结果：农村人口的灾难性卫生支出发生率为14.4%, 致贫率为9.2%, 且两者与地区经济水平呈负相关, 最为贫困的西部灾难性卫生支出发生率及致贫率最高,分别为15.8% 和10.8%; 有住院病人的农村家庭发生灾难性卫生支出和致贫的风险最大。结论与建议：中国农村灾难性卫生支出发生率较高是受多种因素共同影响的结果。其中，新农合制度的保障水平不高，缺乏遏制医疗费用快速上涨有效机制，特别是现存以服务项目付费为主导的支付方式，是导致农村灾难性卫生支出发生率较高的主要制度成因。因此，应以完善新型农村合作医疗的制度设计为重点，加大政府对医疗机构的投入，强化各种配套制度和机制的安排。 |
| 关键词:灾难性卫生支出 因病致贫 农村 |
| 基金项目:国家自然科学基金（71073044）；CMB杰出教授基金(09-979) |
|
| Analysis on causes of catastrophic health expenditure in rural China from perspective of system analysis |
|
|
| Abstract:Objective: The health status of rural population is closely related to the future of the sustainable development of China It is a serious phenomenon that rural households are impoverished from medical expenses In our study, we used the incidence of catastrophic health expenditure and impoverishment from medical expenses as the tool to measure the financial level of New Rural Cooperative Medical Scheme(NRCMS) Methods: We analyzed the data from the Fourth National Health Service Survey and adopted the method of WHO to calculate the incidence of catastrophic health expenditure and impoverishment Results: The incidence of catastrophic health expenditure in rural China was 144% and the incidence of impoverishment was 92%; the factors of family income level and their living regions are inversely associated with it The poor Western region, compared to the Eastern and the Central region, suffered the highest incidence of catastrophic health expenditure and impoverishment, which was 158% and 108% respectively The rural families having members being hospitalized subjected to the highest risk to suffer catastrophic health expenditure and impoverishment Conclusions and suggestions: Relative high level of catastrophic medical expenditure and impoverish rate in rural areas are the results of joint actions of many factors, among them, limited financial protection level, of NRCMS, ineffective mechanism to control the rising medical cost and the dominant payment method of pay for service are the major underlying causes for it Therefore, more comprehensive strategies are needed to conquer those problems |
| Key words:Catastrophic health expenditure Impoverishment from medical expenses Rural areas |
| 摘要点击次数: 2863 全文下载次数: 3182 |
|
|
|
|
|
