我国重特大疾病医疗救助因病致贫对象界定方法研究——基于湖北省M市实证

目的:验证基于重特大疾病相对费用理论,以灾难性和致贫性卫生支出方法为核心的因病致贫对象界定思路的效果。方法:通过实证分析灾难性和致贫性卫生支出的改进方法与理论方法之间的差异,同时将界定出的因病致贫对象与实际救助情况比较分析界定效果。结果:调查地区住院患者家庭灾难性卫生支出发生比例约20%,并呈现出低收入和高收入人群聚集性。致贫性卫生支出发生比例约12%,主要聚集在贫困线边缘家庭。而实际上基于灾难性和致贫性卫生支出方法界定的因病致贫家庭中有70%并未得到医疗救助。结论:基于重特大疾病相对费用理论和灾难性、致贫性卫生支出方法的因病致贫对象界定方法对于我国重特大疾病因病致贫医疗救助对象的界定具有重要价值。通过分组改进方法在保证界定效果的前提下有效提高了因病致贫界定方法的可操作性。

The method of defining poverty caused by illness in catastrophic diseases medical assistance systems: A case study of M City in Hubei Province

Objective: In order to validate the effectiveness of methods of defining poverty caused by illness which are based on catastrophic health expenditure and impoverishment health expenditure, originated from relative costs theory. Methods: This paper uses empirical approach to explore the definition methods by comparing the original methods with modified methods and defined population with the actual situation of poverty alleviation. Results: Study results show that the catastrophic health expenditures incurred ratio is about 20% and shows the aggregation of both low-income and high-income groups. The impoverishment health expenditure incurred ratio is about 12% and they mainly are families at the edge of poverty line. This study found that 70% of the families defined based on our method did not receive medical assistance in reality. Conclusion: Therefore, the definition methods based on relative costs theory are of great value in Chinese medical assistance systems for defining poverty caused by illness. Grouping based on household ability to pay could improve the methods'' operability and effectiveness.