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新型农村合作医疗政策设计与灾难性医疗支出的相关性:来自中国农村25个县的证据

Correlation Between New Cooperative Medical Scheme Policy Design and Catastrophic Medical Payment: Evidence From 25 Counties in Rural China.

作者信息

Zhang Linxiu, Li Shaoping, Yi Hongmei, d'Intignano Luisa Majnoni, Ding Yilei

机构信息

Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.

University of Chinese Academy of Sciences, Beijing, China.

出版信息

Asia Pac J Public Health. 2016 Jan;28(1):26-38. doi: 10.1177/1010539515612907. Epub 2015 Oct 28.

Abstract

Few studies have examined the association between the New Cooperative Medical Scheme (NCMS) policy design and its achievement of providing financial protection to rural residents. This study collected data on NCMS policy design and health care spending from 25 counties and rural households in their catchment areas. It shows that on average, NCMS has a growing but small effect on the reduction of catastrophic medical payment (CMP) incidence. If outpatient spending can be reimbursed from an NCMS pooled account, the incidence of CMP before a reimbursement and that after a reimbursement will be reduced. Higher nominal reimbursement rate for inpatient spending at provincial hospitals is correlated with higher incidence of CMP before a reimbursement. Higher ceiling for annual reimbursement from NCMS is associated with lower incidence of CMP after a reimbursement. Thus, NCMS policy design can be improved to strengthen its effects on the reduction of CMP incidence.

摘要

很少有研究探讨新型农村合作医疗制度(新农合)的政策设计与其为农村居民提供经济保护成效之间的关联。本研究收集了25个县及其集水区农村家庭的新农合政策设计和医疗支出数据。结果显示,平均而言,新农合对降低灾难性医疗支出(CMP)发生率的影响虽在增强但仍较小。如果门诊费用能够从新农合统筹账户中报销,报销前后的CMP发生率都会降低。省级医院住院费用的名义报销率较高与报销前较高的CMP发生率相关。新农合年度报销上限较高与报销后较低的CMP发生率相关。因此,可以改进新农合政策设计,以增强其对降低CMP发生率的效果。

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