基于老龄化健康状态分析的医保政策优化研究
发布时间：2019-02-13 07:15
【摘要】：伴随着人口老龄化进程的不断深化,健康老龄化以及老年人医疗费用的问题得到了广泛关注。由于受到数据等各方面因素的限制,我国国内关于分健康状态老年人的医疗费用研究相对较少。本文结合我国第六次人口普查数据和“中国健康与养老追踪调查(CHARLS)"项目搜集的有关老年人医疗费用的数据测算分健康状态老人的医疗费用,针对老龄化程度的日益严重下老年人的医疗卫生服务需求和医疗费用的逐渐加大的问题,以及目前我国医疗保险制度实际报偿额度尤其是农村医疗保险非常低下的问题,提出政府应出资为60岁以上老年人提供额外的自付费用报销。依据老年人在“不能自理”状态下支付的医疗费用占总费用的比例,对自付费用报销比例设定如下标准：60-69岁人群医疗费用自付部分的25%纳入报销范围,70-79岁人群医疗费用自付部分的35%纳入报销范围,80-89岁人群医疗费用自付部分的50%纳入报销范围,90以上岁人群医疗费用自付部分的65%纳入报销范围。同时本文最后根据对Charls数据分析中发现的问题提出了相应的医疗保险制度优化政策建议。
[Abstract]:With the deepening of population aging process, the problem of healthy aging and elderly medical expenses has been paid more and more attention. Due to the limitation of data and other factors, there is relatively little research on the medical cost of the elderly in China. Based on the data of the sixth population Census of China and the data collected by the Chinese Health and Old-age tracking Survey (CHARLS) project on the medical expenses of the elderly, this paper calculates the medical costs of the healthy elderly. In view of the problem of increasing demand for medical and health services and medical expenses of the elderly under the increasingly serious situation of aging, and the problem that the actual compensation amount of medical insurance system in our country, especially the rural medical insurance, is very low at present, It is suggested that the government should provide additional reimbursement for out-of-pocket expenses for people over 60 years of age. According to the proportion of medical expenses paid by the elderly to the total expenses under the condition of "not being able to take care of themselves", the following criteria were set for the proportion of out-of-pocket expenses reimbursed: 25% of the out-of-pocket medical expenses of the 60-69 age group were included in the reimbursement scope. 35% of the out-of-pocket medical expenses of people aged 70-79 years were included in the reimbursement scope, 50% of the medical expenses out-of-pocket portion of the 80-89 years old people were included in the reimbursement scope, and 65% of the medical expenses out-of-pocket portion of the people aged over 90 years were included in the reimbursement scope. At the same time, according to the problems found in the analysis of Charls data, this paper puts forward the corresponding policy recommendations on the optimization of medical insurance system.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F842.684
本文编号：2421309
[Abstract]:With the deepening of population aging process, the problem of healthy aging and elderly medical expenses has been paid more and more attention. Due to the limitation of data and other factors, there is relatively little research on the medical cost of the elderly in China. Based on the data of the sixth population Census of China and the data collected by the Chinese Health and Old-age tracking Survey (CHARLS) project on the medical expenses of the elderly, this paper calculates the medical costs of the healthy elderly. In view of the problem of increasing demand for medical and health services and medical expenses of the elderly under the increasingly serious situation of aging, and the problem that the actual compensation amount of medical insurance system in our country, especially the rural medical insurance, is very low at present, It is suggested that the government should provide additional reimbursement for out-of-pocket expenses for people over 60 years of age. According to the proportion of medical expenses paid by the elderly to the total expenses under the condition of "not being able to take care of themselves", the following criteria were set for the proportion of out-of-pocket expenses reimbursed: 25% of the out-of-pocket medical expenses of the 60-69 age group were included in the reimbursement scope. 35% of the out-of-pocket medical expenses of people aged 70-79 years were included in the reimbursement scope, 50% of the medical expenses out-of-pocket portion of the 80-89 years old people were included in the reimbursement scope, and 65% of the medical expenses out-of-pocket portion of the people aged over 90 years were included in the reimbursement scope. At the same time, according to the problems found in the analysis of Charls data, this paper puts forward the corresponding policy recommendations on the optimization of medical insurance system.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F842.684
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