2003-2010年深圳市参保农民工就医特征分析

目的:分析深圳市农民工医疗保险状况,探讨医保推进过程中存在的问题,为政策的制定和实施提供参考。方法:运用深圳市社会保险管理局统计资料,采用描述性分析的方法,分析指标包括基本特征、医疗服务利用和医保基金。结果:农民工医保人数占医保总人口的50.60%;参保的农民工中,选择农民工医保险种的有60.75%。参保人就医人次总数和人均次数明显增长;门诊医疗人次数远多于住院人次数,均次费用均呈降低趋势。总诊疗费高于总药品费,两者增长趋势合理。农民工医保筹资水平低,基金结余近年减少。结论:深圳市参保农民工就诊意识提升,就医状况改善。医疗费用增长中,诊疗费比例较高。医保基金结余率呈降低趋势,筹资与支付平衡有待进一步合理控制。

Analysis on the Characteristics of Medical Treatment of the Participant in Labor Workers Medical Insurance in Shenzhen from 2003 to 2010

Objective: Analysis Labor Workers Medical Insurance,to investigate the problems in promoting the system.Methods: The data is from Shenzhen Health Bureau in 2003 to 2010.This study concerns the basis situation,the occurrence of medical services and the fund situation.Results: The percentage of people participated in Labor Workers Medical Insurance is 50.6% of all insured person;and the percentage is 60.75% of all insured migrant workers.The numbers of total visits and per capital visits are obviously increased;the outpatient happens more often than the inpatient;the cost per visit of outpatient and inpatient has a decreasing trend.Total medical costs are higher than total drug costs,and they have a consistent growth trends.The fundraising level is lower for Labor Workers,and fund surplus has reduced recent years.Conclusion: The medical awareness and situation of participant is raising.Total medical costs are higher than total drug costs.However,the fund surplus rate reduces.So it is necessary to find the balance point between the financing and paying reasonably.