生育医疗待遇:政策演变、人群差异及优化策略

发布时间：2019-03-01 11:45

【摘要】：生育医疗待遇是包括产前检查、住院分娩、生育并发症、计划生育手术及并发症等费用报销的一揽子政策,它是母婴保健、"全面二孩"生育配套服务、全民生育保障的一项重要内容。通过回顾相关政策演进过程可以看出,改革开放后生育医疗待遇是按户籍、职业区分参保对象的,城镇职工的生育保障起步较早,也相对成熟,而灵活就业人员、职工未就业配偶、农村广大妇女的生育医疗待遇则起步较晚。基于2010年第三期中国妇女社会地位调查数据,从住院分娩费用报销这一主要方面来反映生育医疗待遇总体情况,结果表明,不同人口学特征、政策时期和从业性质的母亲在分娩费用报销方面存在显著性差异。由于在分析期间1989-2010年内母亲生育医疗待遇主要是职工的权益,来自于生育保险基金支付。因此,女性就业非正规化将弱化职工的生育医疗待遇这一政策的保障作用。改变这一状况我们需要:将生育保险中的生育医疗待遇纳入医疗保险中,打破就业身份对生育保障的限制,建立全民性的生育福利制度;推广孕前检查、计划生育手术并发症等服务,扩展生育医疗待遇项目,深化孕产妇保健工作;规范生育的医疗费用支付标准和整合现有法规。
[Abstract]:Maternity medical treatment is a package of policies that include pre-natal check-up, hospital delivery, reproductive complications, family planning surgery and complications, etc. It is a package of maternal and child health care and "comprehensive two-child" birth support services. The birth guarantee of the whole people is an important content. Looking back on the evolution of relevant policies, we can see that after the reform and opening up, fertility medical treatment is classified according to household registration and occupation, and the birth security of urban workers starts early, is also relatively mature, and flexible employment personnel. Workers are not employed spouses, rural women's reproductive medical treatment started later. Based on the data of the third issue of 2010 survey on the social status of Chinese women, this paper reflects the overall situation of reproductive medical treatment from the main aspect of reimbursement of hospital delivery expenses. The results show that different demographic characteristics, There are significant differences between the policy period and the nature of the mother in reimbursement of labor expenses. In the analysis period 1989-2010, maternity medical treatment is mainly the rights and interests of workers, from the maternity insurance fund to pay. Therefore, the non-regularization of female employment will weaken the guarantee function of the policy of maternity medical treatment. To change this situation, we need: to integrate maternity medical treatment in maternity insurance into medical insurance, to break the restriction of employment status on maternity security, and to establish a universal maternity welfare system; We will promote pre-pregnancy screening, family planning complications and other services, expand maternity medical treatment programs, deepen maternal health care, standardize payment standards for medical expenses for childbirth and consolidate existing laws and regulations.
【作者单位】：上海社会科学院城市与人口发展研究所;
【基金】：国家哲学社会科学基金项目“非正规就业女性生育保险问题研究”(项目编号:15BSH044)的阶段性成果
【分类号】：F842.617

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