论文部分内容阅读
目的:对按病种和按费用进行医疗救助的方法所需资金量分别进行测算。方法:应用反事实分析法分别构建了现行政策下按病种和按费用进行医疗救助的测算方法。结果:(1)按现有基本医疗保险保障水平按病种人均救助资金(平均到全部人群)为3.45元;(2)假设基本医疗保险对试点病种医药费用的实际补偿比例达到70%,按病种人均救助资金为1.82元;(3)假设补充大病医疗保险补偿比例为50%,按费用人均救助资金为6.08元。结论:重大疾病年人均住院救助筹资水平低于6元的地区建议开展以病种为主的救助方式。
OBJECTIVE: To estimate the amount of funds required for medical assistance by disease type and cost. Methods: The methods of counterfactual analysis were used to construct the medical assistance measures by disease type and cost according to the current policy. Results: (1) According to the current level of basic medical insurance coverage, the average per capita relief fund (averaged to the entire population) was 3.45 yuan; (2) Assuming that the actual compensation rate of the basic medical insurance for the pilot medical expenses reached 70% According to the disease, the average per capita relief fund is 1.82 yuan; (3) Assuming the proportion of supplementary medical insurance for serious illness compensation is 50%, the per capita relief fund is 6.08 yuan. Conclusions: In areas with major illness, the average per capita hospitalization aid level is less than 6 yuan, it is recommended to start a disease-based rescue.