新农合患者大病医疗救助水平分析——以湖北省A地和贵州省B地为例

目的:分析A、B两地大病医疗救助情况,为提高大病医疗救助水平和保障效果提出可行性建议。方法:选取湖北省A地和贵州省B地,2013年通过现场调查获取问卷872份,分析大病医疗救助受益患者的概况,计算救助前后年度自付费用以及灾难性卫生支出发生率、相对差距。结果:大病医疗救助对患者经济负担缓解作用有限;目前大病医疗救助政策救助比偏低,救助范围较窄,非五保、低保大病患者救助起付线高且年救助封顶线低,导致实际救助比远低于政策救助比。结论:逐步拓宽大病患者合规费用救助范围并提高救助比;做好大病医疗救助与大病医疗保险、基本医疗保险的有效衔接;将大病门诊自付费用纳入大病医疗救助范围。

Study on the status of catastrophic disease medical assistance under NRCMS in A City at Hubei Province and B County at Guizhou Province

Objective: This paper designs to analyze the status of catastrophic disease medical assistance in A and B regions, and put forward feasible suggestions to improve the medical assistance level and financial effects. Methods: We selected A city at Hubei province and B county at Guizhou province as sample areas, and obtained 872 copies of questionnaires in the field survey. Then, out-of-pocket health expenditure per year, the incidence, and relative gap of catastrophic health expenditure before and after the financial aid were calculated. Results: Catastrophic disease medical assistance plays a limited role in relieving patients' economic burden. Low financial aid rate, narrow range, high deductibles and low ceiling level are responsible for much lower effective financial aid rate. Conclusion: Raise financial aid rate and widen the scope of medical assistance gradually; Establish effective link-up between catastrophic disease medical assistance and catastrophic disease insurance /basic medical insurance; Put outpatient OOP into the scope of catastrophic disease medical assistance.