[1]宋曙光,林 源.大病医疗救助与大病保险衔接的实证研究[J].卫生经济研究,2024,41(03):24-26,31.
　SONG Shuguang,LIN Yuan.An Empirical Study on the Connection between Serious Disease Medical Assistance and Serious Disease Insurance[J].Journal Press of Health Economics Research,2024,41(03):24-26,31.
点击复制

大病医疗救助与大病保险衔接的实证研究
分享到：

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
41
期数:
2024年03期
页码:
24-26,31
栏目:
医疗保障
出版日期:
2024-02-28

文章信息/Info

Title:
An Empirical Study on the Connection between Serious Disease Medical Assistance and Serious Disease Insurance
作者:
宋曙光1; 林 源2
1.怀化学院法学与公共管理学院，湖南 怀化 418008
2.湖南财政经济学院财政金融学院，湖南 长沙 410205
Author(s):
SONG Shuguang;  LIN Yuan
School of Law and Public Administration, Huaihua University,Huaihua Hunan 418008, China
关键词:
大病医疗救助; 大病保险; 制度衔接
Keywords:
serious disease medical assistance;  serious disease insurance;  system connection
分类号:
F840.684
文献标志码:
A
摘要:
目的：实证分析大病医疗救助和大病保险的衔接情况。方法：选取湖南省A市的B、C两地为调查区域，以区域政策文件为主要研究文本，结合实地走访、问卷调查、座谈等方式，从人口覆盖、服务覆盖、费用覆盖、结算、资金筹集五方面分析制度衔接状况。结果：大病医疗救助与大病保险制度存在衔接缝隙；大病医疗救助进一步减轻了救助对象经济负担，但效果有限；结算衔接在时间、空间上未能完全协同；大病医疗救助资金不足制约衔接效果。建议：统一大病医疗救助与大病保险的保障对象认定思路，协同起付线与封顶线，加大门诊医疗费用纳入大病医疗救助的力度，统筹大病医疗救助与大病保险资金，搭建制度衔接的信息化平台。
Abstract:
Objective To empirically analyze the connection between serious disease medical assistance and serious disease insurance. Methods B and C county of A city in Hunan Province were selected as the investigation area, and regional policy documents were used as the main research text. Combined with field visits, questionnaires, and interviews, the system connection was analyzed in terms of population coverage, service coverage, cost coverage, settlement, and fund-raising. Results There were gaps in the connection between serious disease medical assistance and serious disease insurance. The serious disease medical assistance further reduced the financial burden of the recipients, but the effect of the assistance was limited. The connection of the settlement failed to be fully synergized in time and space. The effect of the connection was constrained by the insufficiency of funds for serious disease medical assistance. Conclusion It is necessary to unify the idea of identifying the objects of serious disease medical assistance and serious disease insurance, coordinate the deductible and the cap line, increase the efforts of including outpatient medical expenses in serious disease medical assistance, coordinate the funds of serious disease medical assistance and serious disease insurance, and to build an information platform for the connection of the systems.

参考文献/References:

[1] 张惠敏.重特大疾病保障与救助制度的产生与问题探讨[J].市场周刊（理论研究），2015（08）：104-105.
[2] 张颖.基于协同理论的大病医疗救助与大病保险衔接优化研究[D].武汉：华中科技大学，2017.
[3] 陈成文.论大病医疗救助与新时代“弱有所扶”[J].社会科学家，2018（1）：51-56.

相似文献/References:

[1]徐 伟,杜珍珍.大病保险实施效果评价——以江苏省A市为例[J].卫生经济研究,2016,(09):54.
[2]成 呈.大病医疗救助对象范围与救助标准探讨[J].卫生经济研究,2016,(11):47.
[3]李玉华.保险公司对大病保险费用管控的实践与思考[J].卫生经济研究,2017,(03):25.
[4]李军山,何媛媛,吴海波,等.江西省商业保险公司承办大病保险的问题、原因及对策[J].卫生经济研究,2017,(03):29.
[5]王晓茹,李银山,王 瑶,等.宁南地区新农合大病患者医疗费用负担分析[J].卫生经济研究,2017,(10):30.
[6]李 阳,段光锋,袁 丽,等.我国我国大病保险发展趋势分析[J].卫生经济研究,2018,(04):17.
[7]王雪峰,辛艳姣,蒋俊男,等.中西部地区农村住院患者家庭聚集性及经济负担分析[J].卫生经济研究,2019,(01):22.
　WANG Xue-feng,XIN Yan-jiao,JIANG Jun-nan,et al.Analysis of Family Aggregation and Economic Burden of Rural Inpatients in Central and Western China[J].Journal Press of Health Economics Research,2019,(03):22.
[8]姜学夫,吴君槐.城乡居民大病保险补偿方案精准性探究[J].卫生经济研究,2019,(04):13.
　JIANG Xue-fu,WU Jun-huai.Study on the Accuracy of Compensation Plan for Major illness Insurance for Urban and Rural Residents[J].Journal Press of Health Economics Research,2019,(03):13.
[9]吴海波,周 桐,刘统银.我国大病保险实施进展、存在问题及发展方向[J].卫生经济研究,2019,(04):18.
　WU Hai-bo,ZHOU Tong,LIU Tong-yin.Progress，Problems，and Development Direction of Implementation of Major Illness Insurance in China[J].Journal Press of Health Economics Research,2019,(03):18.
[10]李洁莹,田文华.上海市居民大病保险筹资个人缴费意愿研究[J].卫生经济研究,2020,(07):52.
　LI Jie-ying,TIAN Wen-hua.Research on Shanghai Resident's Willingness to Pay Funds for Critical Illness Insurance Finacing[J].Journal Press of Health Economics Research,2020,(03):52.

更新日期/Last Update: 2024-02-28