长春市医疗保险大病保障制度的探究

发布时间：2018-04-29 03:28

本文选题：医疗保险 + 城镇居民　；参考：《吉林大学》2014年硕士论文

【摘要】：目的：通过对医疗保险重大疾病保障制度建设的历史沿革和发展现状进行调研和分析，结合长春市自身情况，，借鉴国内外重大疾病保障制度建设的先进经验，探索适合长春市医疗保险发展的重大疾病保障机制。方法：本文通过文献研究法、调查法和综合思维法等方法对长春市医疗保险重大疾病保障制度的现状进行调查研究。采用描述性分析方法，对2012年和2013年这两年长春市城镇居民医保40种重大疾病患者的数据进行处理，运用文献研究法对城镇居民40种重大疾病保险政策的运行情况进行分析研究。结果： 2013年长春市城镇居民40种重大疾病保险政策出台后，较2012年在重大疾病患者住院人次、住院人数、人次人头比、住院统筹报销值、报销比例等几方面都有了大幅度的上升，而在住院费用和住院天数等方面有所下降。而且在2012年和2013年，40种重大疾病患者几乎全部选择在三级医院住院就医，住院患者以男性居多，住院患者年龄段大多数在40 80岁，该重大疾病政策所惠及的患者主要所属于是长春社会医疗保险管理局。结论：重大疾病保障制度的建设，切实地提高了重大疾病患者的报销待遇，减少了大病患者的后顾之忧，减少“因病致贫、因病返贫”现象的发生，体现了我国医疗保险制度在“坚持广覆盖、保基本、可持续原则的同时，加强对重大疾病患者的救助”的宗旨；医保应加大对预防保健的投入，要提升民众的体检意识，降低小病变大病的可能。
[Abstract]:Objective: Through the investigation and analysis of the historical evolution and development status of the medical insurance system for major diseases, and in combination with the situation of Changchun, we can learn from the advanced experience of the construction of the major disease security system at home and abroad. To explore a major disease protection mechanism suitable for the development of medical insurance in Changchun. Methods: This paper investigates and studies the current situation of the medical insurance system of major diseases in Changchun by the methods of literature research, investigation and comprehensive thinking. Using descriptive analysis method, the data of 40 major diseases of urban residents in Changchun in 2012 and 2013 were analyzed. The operation of 40 major diseases insurance policy for urban residents is analyzed by using literature research method. Results: After the promulgation of the insurance policy for 40 major diseases of urban residents in Changchun in 2013, compared with 2012, there has been a significant increase in the number of hospitalizations, the head-to-head ratio of person-times, the total reimbursement value of hospitalization, the proportion of reimbursement claims, and so on. However, the cost of hospitalization and the number of days in hospital decreased. Moreover, in 2012 and 2013, almost all of the patients with 40 major diseases chose to be hospitalized in tertiary hospitals. The majority of the hospitalized patients were men, most of whom were in their 40s and 80s. This major disease policy benefits patients mainly belong to the Changchun Social Medical Insurance Bureau. Conclusion: The construction of the safeguard system for major diseases has effectively improved the reimbursement treatment of patients with major diseases, reduced the worries of patients with serious illnesses, and reduced the occurrence of the phenomenon of "poverty caused by illness and returning to poverty because of illness." It embodies the purpose of our medical insurance system to "strengthen the assistance to patients with major diseases while adhering to the principle of broad coverage, basic and sustainable coverage," and that medical insurance should increase investment in preventive health care and raise the public's awareness of physical examination. Reduce the likelihood of serious disease with small lesions.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R197.1;F842.684

【参考文献】