私人医疗保险对中国全民健康覆盖目标的影响：系统文献综述。
The Effects of Private Health Insurance on Universal Health Coverage Objectives in China: A Systematic Literature Review.
机构信息
Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK.
Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Edinburgh EH8 9LD, UK.
出版信息
Int J Environ Res Public Health. 2020 Mar 19;17(6):2049. doi: 10.3390/ijerph17062049.
BACKGROUND
We conducted a systematic review on the role of private health insurance to complement the social health insurance system towards achieving universal health coverage in China. This review presents the impacts of private health insurance on expanding coverage, increasing access to healthcare, and financial protection.
METHODS
A systematic review was conducted by searching peer-reviewed articles published between January 2000 and March 2018 in Web of Science, PubMed, and China Knowledge Resource Integrated Database. The search terms included coverage prevalence, access and financial protection related to private health insurance in China. A total of 31 studies were selected.
RESULTS
Coverage prevalence of private health insurance gradually increased but it was unequally distributed across regions and populations. The expansion of social health insurance has enhanced the total aggregate premium of private health insurance but has had a mixed impact on the take-up of private health insurance. Private insurance beneficiaries were found to limit their utilisation of healthcare services and there was no evidence that it ensured financial protection.
CONCLUSION
The role of private health insurance (PHI) in extending universal health coverage in China was limited and therefore should not be overstated.
背景
我们进行了一项系统评价，研究私人医疗保险在补充社会医疗保险体系以实现中国全民健康覆盖方面的作用。本综述介绍了私人医疗保险在扩大覆盖范围、增加医疗服务可及性和财务保护方面的影响。
方法
在 Web of Science、PubMed 和中国知识资源综合数据库中，检索了 2000 年 1 月至 2018 年 3 月期间发表的同行评议文章，开展了系统评价。检索词包括覆盖范围、与中国私人医疗保险相关的可及性和财务保护。共选择了 31 项研究。
结果
私人医疗保险的覆盖范围逐渐扩大，但在地区和人群之间分布不均。社会医疗保险的扩大提高了私人医疗保险的总保费总额，但对私人医疗保险的参保率产生了混合影响。私人保险受益人的医疗服务利用率受到限制，且没有证据表明其能确保财务保护。
结论
私人医疗保险在中国扩大全民健康覆盖方面的作用有限，因此不应夸大其作用。
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