论文部分内容阅读
目的:分析参保患者的年度医疗费用总负担及个人费用负担。方法:利用2014年全国34个城市基本医疗保险参保患者医疗服务利用抽样调查数据进行分析。结果:参保患者年人均医疗费用总负担为5 383元,主要集中于高级别医疗机构;人均个人费用负担为1 828元,约占总费用负担的34%;住院负担比重高于门诊负担;职工医保患者总负担是居民医保患者的2.40倍,但其个人负担比例远低于居民医保。结论:要积极推进分级诊疗,引导常见病门诊和住院向基层医疗机构分流,减轻医疗费用总体负担;同时要加强医疗服务监管,提高医疗服务利用的合理性,减少不必要花费。
OBJECTIVE: To analyze the total annual medical expenses and the individual expenses of insured patients. Methods: By using the sample survey data of medical service of patients insured in 34 cities in 2014 in China, the data were analyzed. Results: The total annual medical expenses of insured patients was 5 383 yuan, mainly in high-level medical institutions; the per capita individual cost burden was 1,828 yuan, accounting for 34% of the total cost burden; the proportion of hospitalization burden was higher than the outpatient burden; Employee Medicare patients have a total burden of 2.40 times of residents Medicare patients, but the proportion of their individual burden is far lower than that of residents Medicare. Conclusion: It is necessary to actively promote the grading diagnosis and treatment, guide the outpatient and outpatient of common diseases to the primary medical institutions and reduce the overall burden of medical expenses. At the same time, it is necessary to strengthen the supervision of medical services and increase the rationality of medical service utilization and reduce unnecessary costs.