摘要
目的:通过分析湖北省仙桃市农村地区儿童住院服务需求及医保实际补偿情况,了解目前该市农村儿童的住院保障水平。方法:通过机构调查获取儿童住院信息,网络检索相关政策信息以及专家小组访谈;运用Excel 2010和SPSS19.0统计软件进行分析。结果:0~4岁儿童住院率达到25.5%;儿童住院实际补偿比(44.7%)低于全人群实际补偿水平(49.9%),与2013年相比,实际补偿比下降了6个百分点;儿童市外就医比例(15.4%)明显高于全人群(10.1%),报销目录外费用所占比与全人群相差不大。结论与建议:降低儿童住院费用起付标准,提高补偿比例,并做好异地就医结算工作,加大儿科医疗资源投入。
Objective： To learn about the current medical security level of hospitalization expenses for rural children in Xiantao City,Hubei Province through the analysis of the inpatient service demand and the actual medical insurance compensation level. Methods： Access to hospitalization information for children through institutional survey; Focus group interview; Using Excel 2010 and SPSS19. 0 software to analyze data. Results： The hospitalization rate for children aged 0 -4 reaches 25. 5%. Their actual inpatient reimbursement rate,which is only 44. 7%,is lower than the total population. The proportion of the expenditures out of the reimbursement directory is almost equal between the children and total population.Conclusion： This paper suggests to reduce the deductibles and increase the reimbursement rate of children＇s medical security,improve the settlement on ecdemic medical care,and increase the investment of pediatric medical resources.
作者
辛艳姣
项莉
XIN Yan-jiao XIANG Li(School of Social Medicine and Health Management, Huazhong University of Science and Technology, Wuhan Hubei 430030, Chin)
出处
《中国卫生政策研究》
CSCD
北大核心
2017年第2期69-73,共5页
Chinese Journal of Health Policy
基金
国家自然科学基金(71203068
71573095)
关键词
儿童
住院服务需求
医疗保险
保障水平
Children
Inpatient demand
Health insurance
Security level
