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目的估计四川省城镇职工家庭0~18岁儿童口腔保险的筹资水平,为儿童口腔保险的开展和政策制定部门提供参考意见。方法利用ILO模型对某专科口腔医院儿童口腔科7个月的门诊电子病历数据,结合全国第三次口腔流行病调查数据、国家卫计委等统计数据进行分析。结果将儿童口腔疾病诊断数据划分为3个等级,1级是预防性治疗,级别越高治疗程度越复杂。为了提高预防性治疗的使用率,预防性治疗100%的报销。按照级别越低报销程度越高的思路进行分级报销。利用ILO模型测算出2015年四川城镇儿童口腔保险筹资水平为每个儿童家庭缴纳保费125.04元/年,可以建立以预防为主的儿童口腔保险。结论结果显示较低的年费用就可以支撑以预防为主的儿童口腔保险的开展,建议卫生政策制定部门尽快将儿童口腔疾病纳入到基本医疗保险,可以更有效的保障儿童口腔健康。
Objective To estimate the financing level of oral insurance for children aged 0 ~ 18 in urban families in Sichuan province and provide reference for the development of child oral insurance and policy making departments. Methods The ILO model was used to analyze the outpatient electronic medical record data of children’s stomatology department in a specialty stomatology hospital for 7 months. The data of the third national epidemiological survey of mouth disease and the State Health Planning Commission were analyzed. Results The diagnostic data of children’s oral diseases were divided into three grades, one grade is preventive treatment, the higher the grade, the more complicated the treatment. In order to increase the use of prophylactic treatment, preventive treatment of 100% reimbursement. In accordance with the level of higher reimbursement of the idea of a higher level of reimbursement. Using ILO model to calculate the level of children’s oral insurance in Sichuan in 2015 to pay 125.04 yuan / year for each children’s family, we can establish a preventive oral insurance for children. Conclusions The results show that lower annual fees can support the prevention of child oral insurance. It is suggested that health policy-making departments should include child oral diseases as soon as possible in basic medical insurance so as to effectively protect children’s oral health.