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目的:评估新型农村合作医疗补偿对农村居民灾难性卫生支出的影响。方法:分析新型农村合作医疗补偿前后疾病经济风险和灾难性卫生支出的变化情况。结果:新型农村合作医疗报销前后,农村居民处于中高疾病风险的比例由8.25%下降到6.75%;在40%的标准下,报销前后灾难性卫生支出的发生率分别为16.50%和13.50%、灾难性支出差距分别为5.14%和3.63%、灾难性支出相对差距分别为31.16%和26.89%、集中指数分别为-0.3152和-0.3259。结论:低收入家庭疾病经济风险和灾难性卫生支出发生率较高;灾难性卫生支出的相对差距较高;新型农村合作医疗需要进一步提高补偿方式公平性;综合应用家庭经济风险和灾难性卫生支出评价家庭医疗支出更科学合理。
Objectives: To assess the impact of new rural cooperative medical care (CMS) compensation on disastrous health expenditure of rural residents. Methods: To analyze the changes of economic risks and disastrous health expenditures before and after compensation in new rural cooperative medical system. Results: Before and after the reimbursement of new rural cooperative medical system, the proportion of rural residents who were at risk of middle and high disease dropped from 8.25% to 6.75%. Under the 40% standard, the incidence of catastrophic health expenditure before and after reimbursement was 16.50% and 13.50% respectively. The disparity in expenditures was 5.14% and 3.63% respectively. The relative disastrous expenditures were 31.16% and 26.89% respectively. The concentration indices were -0.3152 and -0.3259, respectively. Conclusion: The economic risk of disease in low-income families and the incidence of catastrophic health expenditure are relatively high; the relative gap between disastrous health expenditures is relatively high; the new-type rural cooperative medical care needs to further improve the fairness of compensation; the comprehensive application of family economic risk and catastrophic health expenditure Evaluation of family medical expenses more scientific and rational.