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目的:梳理上海市基本医疗保障制度、救助政策的制度,救助对象的实际医疗费用负担以及救助实施效果。方法:利用上海市民政局救助数据分析救助对象医疗费用负担、医疗救助效果和救助前后灾难性卫生支出发生情况。结果:2015年,上海市医疗救助对象的人均医疗费用17 344元,自负费用占总医疗费用的27.37%。救助对象人均救助金额为2 276元,救助后自负费用降低了13.12个百分点。救助前发生灾难性卫生支出人数占总人数比例为36.23%,救助后发生灾难性卫生支出人数比例降为25.09%。结论:上海市医疗救助对降低自负费用作用、减少灾难性卫生支出较为明显,不同人群的救助水平有所差异。建议要实现救助对象的基本医保全覆盖,完善与基本医疗保险制度的衔接,进一步提高救助水平。
Objective: To sort out the basic medical insurance system in Shanghai, the system of assistance policies, the actual burden of medical assistance and the effect of the bailout. Methods: Using the rescue data of Shanghai Civil Affairs Bureau to analyze the burden of medical expenses, the effect of medical aid and the occurrence of catastrophic health expenditure before and after the rescue. Results: In 2015, the per capita medical expenses for medical assistance in Shanghai was RMB17,344, and the self-expending expenses accounted for 27.37% of the total medical expenses. The per capita assistance amount to aid recipients was 2,276 yuan, a drop of 13.12 percentage points on the self-support expenses after the rescue. The proportion of catastrophic health expenditures before the rescue was 36.23% of the total, and the proportion of catastrophic health expenditures after the rescue was reduced to 25.09%. Conclusion: Shanghai medical aid can reduce the cost of self-sufficiency, reduce disastrous health expenditure more obviously, and the salvage level of different groups is different. It is suggested that the coverage of the basic medical insurance for the rescue recipients should be fully realized, the connection with the basic medical insurance system should be improved, and the level of assistance should be further raised.