W市城鎮(zhèn)職工基本醫(yī)療保險費用控制及影響因素研究
發(fā)布時間：2018-09-12 11:11
【摘要】：在我國,社會醫(yī)療保險制度正在全國范圍內(nèi)逐步改革和推廣,改革后的醫(yī)療保險制度是否能夠?qū)崿F(xiàn)用比較合理的費用提供比較優(yōu)質(zhì)的醫(yī)療服務(wù),從而實現(xiàn)滿足廣大群眾基本醫(yī)療服務(wù)需求的目標,既關(guān)系著廣大人民群眾的切身利益能否實現(xiàn),又關(guān)系到新的醫(yī)療保險制度是否能持續(xù)運行。 城鎮(zhèn)職工基本醫(yī)療保險作為社會醫(yī)療保險制度的重要內(nèi)容,是為勞動者在因生病而蒙受經(jīng)濟損失之后給予一定經(jīng)濟補償時建立的一項醫(yī)療保險制度。城鎮(zhèn)職工基本醫(yī)療保險制度實行單位和個人按一定比例共同繳費,參保職工生病產(chǎn)生的醫(yī)療費用由醫(yī)療保險經(jīng)辦機構(gòu)通過醫(yī)療保險基金給付參保人員一定的經(jīng)濟補償,從而減輕參保人員因生病和治療等醫(yī)療需求所承受的經(jīng)濟負擔。 在w市實行城鎮(zhèn)職工基本醫(yī)療保險以來,醫(yī)療保險費用的支出也不斷上漲,醫(yī)院、患者之間的信息不對稱導致了道德風險的存在。如果不加強w市城鎮(zhèn)職工基本醫(yī)療保險費用的控制,醫(yī)療保險基金將出現(xiàn)收不抵支的狀況,這將會影響到基金的使用,城鎮(zhèn)職工基本醫(yī)療保險制度的持續(xù)發(fā)展將會受到威脅。因此,遏制w市城鎮(zhèn)職工基本醫(yī)療保險費用的不合理增長勢在必行。 本文運用了經(jīng)濟學、統(tǒng)計學方法,從w市城鎮(zhèn)職工基本醫(yī)療保險的實際情況出發(fā),從需求方和供給方兩方面建立影響城鎮(zhèn)職工基本醫(yī)療保險費用支出的模型。根據(jù)模型的建立和分析,并結(jié)合國外和國內(nèi)典型城市醫(yī)療保險費用控制的可借鑒經(jīng)驗,針對W市城鎮(zhèn)職工基本醫(yī)療保險費用控制提出合理性建議,從而推進W市城鎮(zhèn)職工基本醫(yī)療保險制度的順利實施。
[Abstract]:In China, the social medical insurance system is gradually being reformed and popularized throughout the country. Will the reformed medical insurance system be able to provide relatively high quality medical services at a more reasonable cost? Thus, the goal of meeting the basic medical service needs of the masses is not only related to whether the vital interests of the masses can be realized, but also whether the new medical insurance system can continue to operate. As an important part of the social medical insurance system, the basic medical insurance for urban workers is a medical insurance system which is established for workers when they give certain economic compensation after they have suffered economic losses due to illness. The basic medical insurance system for urban staff and workers shall be jointly paid by units and individuals in a certain proportion. The medical expenses arising from the illness of the insured workers shall be paid by the medical insurance agencies through the medical insurance fund to pay certain economic compensation to the insured personnel. Thus reducing the insured due to illness and treatment and other medical needs to bear the economic burden. Since the implementation of basic medical insurance for urban workers in w city, the expenditure of medical insurance costs has also been rising, and the asymmetric information between hospitals and patients has led to the existence of moral hazard. If we do not strengthen the control of the cost of basic medical insurance for urban staff and workers in w city, the medical insurance fund will appear the situation that the income does not exceed the expenditure, which will affect the use of the fund, and the sustainable development of the basic medical insurance system for urban workers will be threatened. Therefore, it is imperative to curb the unreasonable increase of the cost of basic medical insurance for urban workers in w city. Based on the economic and statistical methods and the actual situation of the basic medical insurance for urban workers in w city, this paper sets up a model from the demand side and the supply side, which affects the expenditure of the basic medical insurance expenses of the urban workers. According to the establishment and analysis of the model, combined with the experience of medical insurance cost control in foreign and domestic typical cities, this paper puts forward some reasonable suggestions for the cost control of basic medical insurance for urban workers in W city. Thus, the implementation of the basic medical insurance system for urban workers in W City is carried out smoothly.
【學位授予單位】：西南交通大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：F842.684
本文編號：2238823
[Abstract]:In China, the social medical insurance system is gradually being reformed and popularized throughout the country. Will the reformed medical insurance system be able to provide relatively high quality medical services at a more reasonable cost? Thus, the goal of meeting the basic medical service needs of the masses is not only related to whether the vital interests of the masses can be realized, but also whether the new medical insurance system can continue to operate. As an important part of the social medical insurance system, the basic medical insurance for urban workers is a medical insurance system which is established for workers when they give certain economic compensation after they have suffered economic losses due to illness. The basic medical insurance system for urban staff and workers shall be jointly paid by units and individuals in a certain proportion. The medical expenses arising from the illness of the insured workers shall be paid by the medical insurance agencies through the medical insurance fund to pay certain economic compensation to the insured personnel. Thus reducing the insured due to illness and treatment and other medical needs to bear the economic burden. Since the implementation of basic medical insurance for urban workers in w city, the expenditure of medical insurance costs has also been rising, and the asymmetric information between hospitals and patients has led to the existence of moral hazard. If we do not strengthen the control of the cost of basic medical insurance for urban staff and workers in w city, the medical insurance fund will appear the situation that the income does not exceed the expenditure, which will affect the use of the fund, and the sustainable development of the basic medical insurance system for urban workers will be threatened. Therefore, it is imperative to curb the unreasonable increase of the cost of basic medical insurance for urban workers in w city. Based on the economic and statistical methods and the actual situation of the basic medical insurance for urban workers in w city, this paper sets up a model from the demand side and the supply side, which affects the expenditure of the basic medical insurance expenses of the urban workers. According to the establishment and analysis of the model, combined with the experience of medical insurance cost control in foreign and domestic typical cities, this paper puts forward some reasonable suggestions for the cost control of basic medical insurance for urban workers in W city. Thus, the implementation of the basic medical insurance system for urban workers in W City is carried out smoothly.
【學位授予單位】：西南交通大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：F842.684
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，本文編號：2238823
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