新型农村合作医疗对家庭疾病经济负担影响追踪研究

项目名称： 新型农村合作医疗对家庭疾病经济负担影响追踪研究

项目编号： No.71303166

项目类型： 青年科学基金项目

立项/批准年度： 2014

项目学科： 管理科学

项目作者： 邱培媛

作者单位： 四川大学

项目金额： 19万元

中文摘要： 既往研究表明，新农合主要问题是补偿率低、公平性不足，以及资金结余率高等。在新农合筹资水平逐步提高、门诊统筹逐步建立并扩大的背景下，新农合的保障水平、公平性、资金使用效率有怎样的变化是政府和学术界关注的重要问题。研究团队对四川省2011年机构数据进行分析，发现新农合住院的实际补偿比有所上升，但次均住院费用上涨幅度大；门诊补偿率有所上升，但是覆盖病种较少，受益面有限；而资金结余率普遍较高。为更好的研究新农合对家庭疾病经济负担的影响，本课题拟在2007年研究的基础上，采用纵向设计的研究方案，结合机构和入户调查数据，追踪并评价四川省和湖北省各一个县新农合的运行情况。并应用公平性分析方法、灾难性卫生支出评价方法和多水平模型，探讨新农合对提高公平性和降低灾难性卫生支出的影响。研究结果将为新农合管理提供连续的入户追踪数据，并对如何保护农村家庭免于疾病经济风险和提高新农合的使用效率及公平性提

中文关键词： 新型农村合作医疗；NCMS；灾难性卫生支出；公平性；农村

英文摘要： Previous studies identified low reimbursement rate, insufficient equity, and high cumulative balance ratio as major issues of the New Cooperative Medical Scheme (NCMS). With the increased funding and extended outpatient coverage of the NCMS, how will the reimbursement rate, equity and efficiency change is concerned by governments and academia. By comparing the institutional data of Sichuan Provinces of 2010 and 2011, we found that although the inpatient reimbursement rate increased, the inpatient expenses increased heavily; although the outpatient reimbursement rate increased, not many people benefited from it because of low coverage of disease type; and the cumulative balance ratio is still high. To better understand the impact of the NCMS on family disease burden, this project will be designed as a longitudinal study to evaluate if the increased funding and extended outpatient coverage of the NCMS have provided stronger financial protection for rural population in two counties in Sichuan and Hubei respectively, basic data of which had been collected in the POVILL program in 2007. Gini index, Concentration index, and KaKwani index will be used to evaluate equity of the NCMS. The measurement of catastrophic payment will be used to evaluate catastrophic payment headcount and catastrophic payment gap. And the Mult

英文关键词： New Cooperative Medical Scheme；NCMS；Catastrophic medical expenses；equality；rural