| 摘要: |
| 目的 比较分析2008年和2013年黑龙江居民住院医疗费用、补偿、自付比及致贫率变化情况。方法 利用黑龙江省第四次及第五次卫生服务调查数据，对住院费用、实际补偿、自付比及因病致贫等指标进行分析。结果 2008—2013年，县、县以上医疗机构的次均住院费用增长率高达101.51%和125.75%，且三个级别医疗机构的次均住院间接费用也有不同程度的增长；居民的住院补偿费用增长率高达202.75%，补偿比例也增长了20.48个百分点，其中乡镇/社区中心的实际补偿比例高达71.8%, 居民住院自付费用比平均下降了26.9%；病人住院流向日趋合理，卫生院/社区机构住院人次比增长了12.66个百分点，县以上住院的人次下降了12.65个百分点；家庭因病致贫发生率从2008年的4.21%下降到2013年的2.95%。结论 我国医疗保险制度在增加住院病人费用补偿水平和比例方面做出了不懈的努力，在调整住院病人流向、降低因病致贫发生率等方面发挥了重要的作用。但是，患者次均住院费用及次均住院间接费用大幅增加，提示我国医保制度在医疗费用支付制度改革以及费用控制机制探索方面还面临巨大的挑战，亟待推动相关对策的探索和试点研究。 |
| 关键词: 住院医疗费用 自付比例 补偿 因病致贫 |
| DOI： |
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| Analysis of the Changing Tendency of Inpatient Reimbursement，Copayment Rate and Impoverishment from Medical Expenses of the Patient with Medical Insurance |
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| Abstract: |
| Objective To comparatively analyze inpatient expenses reimbursement，copayment rate and impoverishment from medical expenses of Heilongjiang residents in 2008 and 2013. Methods Data of the family health status were obtained from The Fourth Health Services Survey and The Fifth Health Services Survey of Heilongjiang Province. The variables of inpatient medical cost, actual reimbursement and copayment rate as well as impoverishment from medical expenses were calculated and analyzed. Results From 2008 to 2013, the average hospitalization costs increased rapidly at county or above county level medical institutions, which grew by 101.51% and 125.75% respectively, while the average indirect costs of hospitalization among three level medical institutions also raised rapidly. However, the impatient cost reimbursed also increased by 202.75%, the reimbursement rate increased by 20.48 percent. The actual reimbursement rate for inpatient care at township hospital/community health center reached to 71.8%, the inpatients’ average copayment rate dropped by 26.9%; the pattern of inpatients flow became more rational. The number of inpatients seeking service at township hospitals/community health centers increased by 12.66 percent, while for patients treated at hospitals above county level, it dropped by 12.65 percent; Impoverishment from medical expenses declined from 4.21% in 2008 to 2.95% in 2013. Conclusion China’s medical insurance system makes every effort to increase reimbursement level and rate for inpatients. It also plays an important role in adjusting the flow of inpatients and reducing the impoverishment rate from medical expenses. However, hiking medical expenditure as well as increasing hospitalization indirect costs still pose great challenges to health insurance system for its effort to controlling soaring medical cost and reforming its payment system, relevant studies on policy pilots are urgently needed. |
| Key words: inpatient cost,copayment rate,reimbursment,impoverishment from medical expenses |
