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目的:以患者因就诊所产生费用的实际报销比例为切入点,探讨在近20年各个阶段的医疗保障制度改革对于不同群体的影响。方法:建立计量经济学模型,重点分析不同医疗保障制度随着一系列改革而导致的患者实际报销比例的变化。结果:患者实际报销比例在不同保险项目之间存在着较大的差异,一系列针对于不同人群的医疗保险政策调整对实际报销比例有一定的影响。讨论:不同社会医疗保险制度的报销比例存在较大差异,低家庭收入患者实际报销比例较低。结论:改革在近十年取得了一些成效,但患者的实际报销比例在不同人群不同地区之间仍存在着较大的差异,减少差异使社会医疗保障制度更加趋向于公平应当是下一步政策调整的重点。
OBJECTIVE: To explore the impact of the reform of the medical insurance system in different stages of the past 20 years on different groups based on the actual proportion of patients reimbursed for expenses arising from medical treatment. Methods: The establishment of econometric model, focusing on analysis of different medical insurance system with a series of reforms led to the actual proportion of patients reimbursement changes. Results: The proportion of actual reimbursement among patients varies greatly among different insurance programs. A series of health insurance policy adjustments targeting different groups of people have a certain impact on the actual reimbursement ratio. Discussion: There are big differences in reimbursement rates of different social medical insurance systems, and the actual reimbursement rate of patients with low family income is relatively low. Conclusion: The reform has made some achievements in the past ten years. However, the proportion of patients actually reimbursed in different regions of the population is still quite different. Reducing the difference makes the social medical insurance system more fair and fair, which should be the next policy adjustment the key of.