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1.
本研究通过阐述我国现阶段贫困慢性病患者疾病负担的现状及精准扶贫政策的核心要义,旨在研究分析我国健康精准扶贫政策在实施过程中存在的问题和现实困境,并为制定相关健康精准扶贫政策提供建议。分析发现,我国健康精准扶贫政策在实施过程中存在的问题主要有:贫困人口识别不精准;动态管理与考核机制不精准;扶贫资源配置不精准。针对这些问题,提出如下建议:建立多维贫困识别体系,完善贫困户建档立卡信息;健全精准扶贫动态监管与考核体系;合理配置扶贫资源,推进各项配套政策和制度的创新。  相似文献   

2.
正对于医疗卫生精准扶贫工作,江西省明确23条政策措施,对建档立卡贫困户从"保基本、救大病、管慢病、强基层"4个方面发力,大力推进"健康扶贫"工作,确保贫困群众"健康有人管、患病有人治、治病有报销、大病有救助",有效提高了贫困群众医疗保障水平,全省因病致贫的户数占总贫困户数的比例由2011年的57.1%下降至2015年的44.4%。一个不落资助参合要实现"农村贫困人口基本医疗有保障"的目标,就是要扭转农村贫困群  相似文献   

3.
河南省商丘市U隹阳区在脱贫攻坚精准脱贫工作中,以卫生医疗和保健工作为中心,想群众之所想、急群众之所急,确保了建档立卡贫困户的医疗健康保障工作。强化医疗保障体系建设。为建档立卡贫困人口全额支付了医保参保费用,实现贫困人口参保率100%,按照每人230元标准购买了医疗保障扶贫保险和人身意外伤害保险,在辖区定点医院每年可享受至少一次免费体检.  相似文献   

4.
<正>迈向全面小康,贫困是绕不过去的障碍;建设健康中国,疾病是挡住路程的顽石。据国务院扶贫办建档立卡统计,因病致贫、因病返贫贫困户占建档立卡贫困户总数的42.2%,患大病和患长期慢性病的贫困人口疾病负担重。贫困地区的卫生与健康状况,成为健康中国建设最突出的短板。2016年12月2日,国务院发布了《"十三五"脱贫攻坚规划》,其中将健康扶贫列为十一大行动之一。健康扶贫是指在普惠基础上,通过采取有效  相似文献   

5.
地方动态     
<正>贵州确保贫困村民100%参合贵州省政府办公厅近日印发《贵州省进一步完善医疗保障机制助力脱贫攻坚三年行动方案(2017年~2019年)》明确,2017年,全面落实四重医疗保障制度;全面对罹患儿童先天性心脏病等13种大病的建档立卡农村贫困人口实施集中救治;全面对罹患36种慢性疾病的建档立卡农村贫困人口实施健康管理;确保建档立卡农村贫困人口100%参合;确保建档立卡农村贫困人口医疗费用实际补偿比  相似文献   

6.
正湖北省利川市卫生计生局大力实施健康扶贫,加强统筹协调,多措并举,着力解决利川市农村贫困人口因病致贫、因病返贫问题,全面提高利川市农村贫困人口健康水平,建立健康改善长效机制。一、落实惠民政策,提高保障水平为全面掌握建档立卡农村贫困人口"因病致贫、因病返贫"真实信息,利川市卫计系统完成了6.3万人的调查任务,其中因病致贫近2万人。制定了《利川市农村医疗保障精准扶贫工作实施方案》,将  相似文献   

7.
<正>健康扶贫是精准扶贫工作中难度较大、政策性强、标准很高的一项工作,是打赢脱贫攻坚战的一场关键战役。辽宁省卫生计生委成立了精准健康扶贫领导小组,针对因病致贫、因病返贫问题,精确到户、精准到人,突出重点地区、重点人群、重点病种,以"三提三送"为健康扶贫工作手段,防治并举,分类救治,助力脱贫攻坚。2016年,全省建档立卡贫困人口大病保险实现全覆盖,推动2.86万人脱贫。  相似文献   

8.
<正>汪能保是安徽省金寨县花石乡大湾村的贫困户,2017年被查出患晚期胃癌,手术治疗总共花费97332.09元,按相关政策报销后,他自己仅支付了9300.56元。自党中央、国务院将实施健康扶贫作为精准扶贫、精准脱贫的基本方略以来,无数像汪能保一样的贫困户享受到了基本医疗有保障的雨露滋润。新中国成立70年来,特别是改革开放以来,我国累计有7亿多人口脱贫,贫困发生率下降80%。在全面打响脱贫攻坚战以后,健康扶贫发挥了无可替代的重要作用。在我国建档立卡贫困户中,因病致贫、因病返贫的比例在42%以上,截至2019年6月,全国1435万贫困大病及慢病患者  相似文献   

9.
正"坚持问题导向和目标导向,不松劲、不懈怠,持续在精准施策、精准推进、精准落地上下功夫。"2018年,青海省将以"实施健康中国战略"引领全省卫生计生工作,统一思想,明确方向,把握重点,狠抓落实。为切实做好健康扶贫工作,首先要精准发力促攻坚,认真实施好健康扶贫重病兜底保障、大病救治慢病签约扩面提质等"十大工程",切实抓好贫困地区健康扶贫工作。其次,瞄准重点抓突破,扎实做好农牧区建档立卡贫困户家庭医生签约服务工作,全面落实"双签约"  相似文献   

10.
正贵州省颁发关于坚决打赢扶贫攻坚战的配套文件,推进精准扶贫战略。结合农村人口"因病致贫、因病返贫"比重较高的实际情况,开拓扶贫思路,创新扶贫机制,从提高农村贫困人口医疗救助保障水平入手,构筑基本医疗保险、大病保险、医疗救助扶助"三重医疗保障"网,全面开展医疗健康扶贫,大力提高医疗救助保障水平,缓解农村贫困人口看病贵问题,推动全省扶贫攻坚取得新突破。  相似文献   

11.
This study aims to examine poverty, chronic illnesses, health insurance, and health care expenditures, within the context of a political economy of aging perspective. Subsamples of 1,773 older adults from the Medical Expenditure Panel Survey were selected for analyses. The results showed that chronic illnesses influenced out-of-pocket health care costs. Older persons with more than one health insurance spent less on out-of-pocket health care costs. The results have implications for health care social workers concerned with the growing costs of chronic illnesses, implementing integrated care, and advocating for extending public health insurance coverage especially for our most impoverished older adults.  相似文献   

12.
South Korea introduced mandatory social health insurance forindustrial workers in large corporations in 1977, and extendedit incrementally to the self-employed until it covered the entirepopulation in 1989. Thirty years of national health insurancein Korea can provide valuable lessons on key issues in healthcare financing policy which now face many low- and middle-incomecountries aiming to achieve universal health care coverage,such as: tax versus social health insurance; population andbenefit coverage; single scheme versus multiple schemes; purchasingand provider payment method; and the role of politics and politicalcommitment. National health insurance in Korea has been successfulin mobilizing resources for health care, rapidly extending populationcoverage, effectively pooling public and private resources topurchase health care for the entire population, and containinghealth care expenditure. However, there are also challengesposed by the dominance of private providers paid by fee-for-service,the rapid aging of the population, and the public-private mixrelated to private health insurance.  相似文献   

13.
Pagán JA  Puig A  Soldo BJ 《Health economics》2007,16(12):1359-1369
The lack of health insurance coverage could be a potentially important deterrent to the use of preventive health care by older adults with high rates of chronic co-morbidities. We use survey data from 12 100 Mexican adults ages 50 and older who participated in the 2001 Mexican Health and Aging Study (MHAS) to analyze the relation between health insurance coverage and the use of preventive health-care services in Mexico. Uninsured adults were less likely to use preventive screenings for hypertension, high cholesterol, diabetes and (breast, cervical and prostate) cancer than insured adults. After adjusting for other factors affecting preventive care utilization in a logistic regression model, we found that these results still hold for high cholesterol and diabetes screening. Similar results hold for the population not working during the survey week and for adults earning below 200% of the poverty line. Our results suggest that insured adults are in a relatively better position to detect some chronic diseases - and have them treated promptly - than uninsured adults because they have better access to cost-effective preventive screenings. Recent public policy initiatives to increase health insurance coverage rates in Mexico could lead to substantially higher preventive health-care utilization rates and improvements in population health.  相似文献   

14.
Using Vietnam's latest National Household Survey data for 2001-2002 this paper assesses the influence of individual, household and commune-level characteristics on a woman's decision to seek prenatal care, on the number of prenatal visits, and on the choice between giving birth at a health facility or at home. The decision to use any care and the number of prenatal visits is modeled using a two-part model. A random intercept logistic model is used to capture the influence of unobserved commune-specific factors found in the data regarding a woman's decision to give birth at a health facility rather than at home. The results show that access to prenatal care and delivery assistance is limited by observed barriers such as low income, low education, ethnicity, geographical isolation and a high poverty rate in the community. More specifically, more prenatal visits increase the likelihood of giving birth at a health facility. Having compulsory health insurance increases the odds of giving birth at a health facility for middle and high income women. In contrast, health insurance for the poor increases the likelihood of having more prenatal visits but has little effect on the place of delivery. These results suggest that the existing safe motherhood programs should be linked with the objectives of social development programs such as poverty reduction, and that policy makers need to view both the individual and the commune as appropriate units for policy targeting.  相似文献   

15.
[目的]对比分析农村贫困人口与非贫困人口住院费用及疾病负担情况,为在脱贫攻坚阶段完善健康扶贫政策,预防脱贫人口因病返贫提供借鉴参考。[方法]收集华东地区某大型三级甲等综合医院,应用可解脱弹簧圈栓塞介入治疗颅内动脉瘤破裂的农村贫困人口与非贫困人口的一般人口学、住院费用水平及明细、医保报销数据等资料,运用SPSS 17.0统计软件分析。[结果]贫困人口较非贫困人口自付费用均值降低35,926.94元,报销比例为96.20%,较非贫困人口组高26.77个百分点,其中大病保险支付比例、民政救助支付比例,较非贫困人口组分别高12.05个百分点、8.34个百分点。[结论]该省健康扶贫政策大幅减轻了贫困人口就医负担,医疗费用负担对于非贫困农村居民属灾难性医疗支出,贫困人口消耗了更多的医疗资源。  相似文献   

16.
PURPOSE Long-term shifts in specialty choice and health workforce policy have raised concern about the future of primary care in the United States. The objective of this study was to examine current use of primary and specialty care across the US population for policy-relevant subgroups, such as disadvantaged populations and persons with chronic illness.METHODS Data from the Medical Expenditure Panel Survey from 2004 were analyzed using a probability sample patients or other participants from the noninstitutionalized US population in 2004 (N = 34,403). The main and secondary outcome measures were the estimates of the proportion of Americans who accessed different types of primary care and specialty physicians and midlevel practitioners, as well as the fraction of ambulatory visits accounted for by the different clinician types. Data were disaggregated by income, health insurance status, race/ethnicity, rural or urban residence, and presence of 5 common chronic diseases.RESULTS Family physicians were the most common clinician type accessed by adults, seniors, and reproductive-age women, and they were second to pediatricians for children. Disadvantaged adults with 3 markers of disadvantage (poverty, disadvantaged minority, uninsured) received 45.6% (95% CI, 40.4%–50.7%) of their ambulatory visits from family physicians vs 30.5% (95% CI, 30.0%–32.1%) for adults with no markers. For children with 3 vs 0 markers of disadvantage, the proportion of visits from family physicians roughly doubled from 16.5% (95% CI, 14.4%–18.6%) to 30.1% (95% CI, 18.8%–41.2%). Family physicians constitute the only clinician group that does not show income disparities in access. Multivariate analyses show that patterns of access to family physicians and nurse-practitioners are more equitable than for other clinician types.CONCLUSIONS: Primary care clinicians, especially family physicians, deliver a disproportionate share of ambulatory care to disadvantaged populations. A diminished primary care workforce will leave considerable gaps in US health care equity. Health care workforce policy should reflect this important population-level function of primary care.  相似文献   

17.
农村贫困家庭健康风险及其干预策略   总被引:1,自引:0,他引:1  
贫困与健康的关系已经被很多文献很好地论述了。健康贫困实则为贫困的一个重要部分.农村贫困家庭应对健康风险时具有很强的脆弱性,如果缺乏有效的健康风险处理机制,则很容易进入健康贫困状态。而传统健康保障模式在解决贫困家庭健康风险问题上可能产生以下方面的问题:过分强调公共部门的作用和政府目标:过分强调疾病成本和支出从而忽略可持续发展的健康促进;容易混淆不同部门问的职责,降低相互支持度。基于社会风险管理的理论框架描述了农村贫困家庭健康风险管理预防、缓和及应对策略。  相似文献   

18.
《Global public health》2013,8(6):561-574
Abstract

There is increasing evidence of rising levels of inequality in health care utilisation in the post-socialist countries of Central Asia and the Caucasus. Against this backdrop, we investigate the determinants of accessibility and affordability of health care utilisation in Tajikistan. A modified version of the Andersen Behavioural Model is used to conceptualise the determinants of health care utilisation in Tajikistan. Poisson and Ordered Logit regression models are performed to estimate the determinants of health care utilisation. Empirical results demonstrate that poverty, chronic illness and disability are the most important determinants of health care utilisation and affordability in Tajikistan. Other significant determinants include gender, the level of education of the household head, and the availability of medical personnel at a given population point. These findings suggest an urgent need for health care reform in order to ensure equality in accessibility and affordability for the entire population.  相似文献   

19.
Households obtaining health care services in developing countriesincur substantial costs, despite services generally being providedfree of charge by public health institutions. This constitutesan economic burden on low-income households, and contributesto deepening their level of poverty. In addition to the economicburden of obtaining health care, the method of financing thesepayments has implications for the distribution of householdassets. This effect on resource-poor households is amplifiedsince they have decreased access to health insurance. Recentliterature, however, ignores the importance of the method offinancing health care payments. This paper looks at the caseof Nepal and highlights the impact on households of paying forhospital-based care of Kala-azar (KA) by analysing the catastrophic,impoverishment and economic consequences of their coping strategies.The paper utilizes micro-data on a random selection of 50% ofthe KA-affected households of Siraha and Saptari districts ofNepal. The empirical results suggest that direct costs of hospital-basedtreatment of KA are catastrophic since they consume 17% of annualhousehold income. This expenditure causes more than 20% of KA-affectedhouseholds to fall below the poverty line, with the remaininghouseholds being pushed into the category of marginal poor;the poverty gap ratio is more than 90%. Further, KA incidencecan have prolonged and severe economic consequences for thehousehold economy due to the mechanisms of informal sector financingto which households resort. A heavy burden of loan repaymentscan lead households on a downward spiral that eventually becomesa poverty trap. In other words, the method of financing healthcare payments is an important ingredient in understanding theeconomic burden of disease.  相似文献   

20.

Context

The Affordable Care Act provides new Medicaid coverage to an estimated 12 million low-income adults. Barriers to access or quality could hamper the program''s success. One of these barriers might be the stigma associated with Medicaid or poverty.

Methods

Our mixed-methods study involved 574 low-income adults and included data from an in-person survey and follow-up interviews. Our analysis of the interviews showed that many participants who were on Medicaid or uninsured described a perception or fear of being treated poorly in the health care setting. We defined this experience as stigma and merged our qualitative interviews coded for stigma with our quantitative survey data to see whether stigma was related to other sociodemographic characteristics. We also examined whether stigma was associated with access to care, quality of care, and self-reported health.

Findings

We were unable to identify other sociodemographic characteristics associated with stigma in this low-income sample. The qualitative interviews suggested that stigma was most often the result of a provider-patient interaction that felt demeaning, rather than an internalized sense of shame related to receiving public insurance or charity care. An experience of stigma was associated with unmet health needs, poorer perceptions of quality of care, and worse health across several self-reported measures.

Conclusions

Because a stigmatizing experience in the health system might interfere with the delivery of high-quality care to new Medicaid enrollees, further research and policy interventions that target stigma are warranted.  相似文献   

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