[1]张宇微,陈家应,张 兵,等.城乡居民医保整合后医疗服务利用和费用负担变化研究[J].卫生经济研究,2022,39(7):32-36.
　ZHANG Yuwei,CHEN Jiaying,ZHANG Bing,et al.A Cohort Study on the Changes of Medical Service Utilization and Cost Burden after the Integration of Basic Medical Insurance System for Urban and Rural Residents[J].Journal Press of Health Economics Research,2022,39(7):32-36.
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城乡居民医保整合后医疗服务利用和费用负担变化研究
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
39
期数:
2022年7期
页码:
32-36
栏目:
卫生服务需求
出版日期:
2022-06-30

文章信息/Info

Title:
A Cohort Study on the Changes of Medical Service Utilization and Cost Burden after the Integration of Basic Medical Insurance System for Urban and Rural Residents
作者:
张宇微1; 2; 陈家应2; 3; 张 兵4; 邱 鹏4; 王萱萱1; 2; 石金楼2
1.南京医科大学医政学院，江苏 南京 211166
2.南京医科大学健康江苏研究院，江苏 南京 211166
3.南京医科大学康达学院，江苏 连云港 222000
4.江苏省南通市医疗保障局，江苏 南通 226000
Author(s):
ZHANG Yuwei;  CHEN Jiaying;  ZHANG Bing;  QIU Peng;  WANG Xuanxuan;  SHI Jinlou
School of Health Policy and Management, Nanjing Medical University, Nanjing Jiangsu 211166, China
关键词:
城乡居民医保; 医疗服务利用; 费用负担; 公平性
Keywords:
basic medical insurance for urban and rural residents;  medical service utilization;  medical cost burden;  equality
分类号:
R197
文献标志码:
A
摘要:
目的：分析城乡居民医保制度整合后，城市居民和农村居民医疗服务利用和费用负担的变化。方法：采用队列研究，以门诊和住院补偿人次、次均费用及住院患者机构流向为分析指标，分析研究队列在2010-2018年间的指标变化情况。结果：城乡居民医保制度整合后，城乡居民在医疗服务利用上的不公平性得到缓解，但在费用负担上的不公平性并未得到有效缓解；医保政策对规范居民就医秩序的作用仍较弱。结论：建立约束机制，强化医保对规范就医行为的作用；调整筹资政策，提高城乡居民医疗费用负担公平性；加快医保支付方式改革，提升基层卫生服务能力。
Abstract:
Objective To analyze the changes of medical service utilization and medical cost burden of urban and rural residents after the integration of basic medical insurance system for urban and rural residents. Methods Taking outpatient and inpatient compensation person times, medical flow and average outpatient and inpatient expenses as the analysis indicators of medical service utilization and medical cost burden, a cohort study was conducted to analyze the changes of these indicators from 2010 to 2018. Results The integration of basic medical insurance system for urban and rural residents alleviated the inequality of medical service utilization between urban and rural residents. However, this effect was not observed in cost burden. The current medical insurance system plays a relatively weak role in regulating patients' medical visits. Conclusions A restraint mechanism should be established to strengthen the normative effect of medical insurance on the medical visits. It is suggested to adjust the financing policy to improve the equality of medical cost burden of urban and rural residents. It is recommended to advance the promotion of the reform of medical insurance payment so as to improve the primary care quality.

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更新日期/Last Update: 2022-06-30