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为了科学论证“总额预算+按服务单元付费”组合支付方式对于消除百姓高额医疗费用风险,减轻居民医疗费用负担的效果,研究运用居民家庭灾难性卫生支出发生率指标及其计算方法,利用大规模居民家庭入户调查数据,通过比较分析发现,按项目付费下居民家庭灾难性卫生支出(40%阈值计算)的发生率为5.55%,组合支付方式可使其降低17.88%,且效果远大于现行医疗保障的作用(5.29%)。提示组合支付方式可通过良好的费用共担机制,降低居民家庭灾难性卫生支出的发生。
In order to scientific demonstration of “total budget + pay by service unit” combination of payment methods to eliminate the high cost of people’s health care costs and reduce the burden on residents of the effect of medical costs, research and application of household disastrous health expenditure rate indicators and calculation methods, According to the survey data of large-scale households, we found that the incidence of catastrophic health expenditure (40% threshold calculation) is 5.55% under the project-based payment and the combined payment method can reduce it by 17.88% Far greater than the current role of medical security (5.29%). Prompt combination of payment methods can be through a good cost-sharing mechanism to reduce the incidence of disastrous health spending of households.