中国家庭灾难性医疗支出与大病保险补偿模式评价研究

发布时间：2019-01-17 08:28

【摘要】：本文采用国务院城镇居民基本医疗保险评估入户调查数据,构建医疗服务利用对预期价格敏感性差异的面板门槛模型,发现我国灾难性医疗支出标准应为家庭年度医疗服务自负金额占收入的44.13%;继续建立处理效应模型实证检验灾难性医疗支出的微观作用机理,结果表明:家庭发生灾难性医疗支出后,个人收入将降低0.1163个百分点,个人健康将降低7.9947个单位,个人医疗服务支出将增加0.6344个百分点;基于现行大病保险实践经验提出三种大病保险补偿方案,均可显著降低我国灾难性医疗支出发生率,但从降低幅度和平稳性两个方面比较,以家庭为补偿对象、以家庭灾难性医疗支出作为补偿标准的评估方案则明显优于其他两个方案。
[Abstract]:In this paper, a panel threshold model of the difference in the sensitivity of the utilization of medical services to the expected price is constructed by using the survey data of the basic medical insurance assessment of urban residents under the State Council. It is found that the standard of catastrophic medical expenditure in China should be 44.13% of the income of the annual medical service of the family. The microcosmic mechanism of catastrophic medical expenditure is tested by establishing the treatment effect model. The results show that the personal income will be reduced by 0.1163 percentage points and the personal health will be reduced by 7.9947 units after the catastrophic medical expenditure occurs in the household. The expenditure on personal medical services will increase by 0.6344 percentage points; Based on the practical experience of the current serious illness insurance, three kinds of serious illness insurance compensation schemes are put forward, which can significantly reduce the incidence of catastrophic medical expenditure in China. However, compared with the reduction range and stability, families are taken as the compensation objects. The evaluation scheme based on catastrophic family medical expenditure is superior to the other two schemes.
【作者单位】：南开大学金融学院;中国特色社会主义经济建设协同创新中心;山东财经大学保险学院;北京大学国家发展研究院;中国医疗保险研究会;
【基金】：国家自然科学基金(批准号:11301303) 国家社会科学基金项目(批准号:15BJY007) 中国保险学会教保人身保险高校课题研究基金(批准号:jiaobao2017—07) 泰山学者工程专项经费(批准号:tsqn20161041)资助山东省高等学校优势学科人才团队“机器学习与大数据分析团队(批准号:1716009)”的资助
【分类号】：F126.1;F842.684

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