發(fā)布時(shí)間：2018-02-21 08:21

  本文關(guān)鍵詞： 疾病風(fēng)險(xiǎn)管理 健康管理 商業(yè)健康保險(xiǎn) 新型農(nóng)村合作醫(yī)療　出處：《山東大學(xué)》2013年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：本文首先對(duì)我國(guó)農(nóng)村居民的疾病風(fēng)險(xiǎn)進(jìn)行了評(píng)價(jià),評(píng)價(jià)對(duì)象為我國(guó)農(nóng)村居民面臨的16類(lèi)主要疾病風(fēng)險(xiǎn),評(píng)價(jià)維度包含疾病風(fēng)險(xiǎn)損失概率和疾病風(fēng)險(xiǎn)損失程度。損失概率的衡量采用了疾病別兩周患病率和疾病別慢性病患病率指標(biāo)；損失程度的衡量采用了疾病經(jīng)濟(jì)負(fù)擔(dān)指標(biāo),其中,本文采用了二步模型法和人力資本發(fā)分別測(cè)算了16類(lèi)疾病風(fēng)險(xiǎn)的直接經(jīng)濟(jì)負(fù)擔(dān)和間接經(jīng)濟(jì)負(fù)擔(dān)。根據(jù)疾病風(fēng)險(xiǎn)損失概率和損失程度的衡量結(jié)果,本文繪制了疾病風(fēng)險(xiǎn)分類(lèi)圖,將16類(lèi)疾病風(fēng)險(xiǎn)劃分為五類(lèi),分析了針對(duì)每一類(lèi)疾病風(fēng)險(xiǎn)的風(fēng)險(xiǎn)管理需求。 基于我國(guó)農(nóng)村居民的疾病風(fēng)險(xiǎn)評(píng)價(jià)結(jié)果和疾病風(fēng)險(xiǎn)管理現(xiàn)狀,本文從三個(gè)方面闡明了探索農(nóng)村居民疾病風(fēng)險(xiǎn)管理新模式的必要性。第一,疾病風(fēng)險(xiǎn)管理供給不足,在政府層面,疾病風(fēng)險(xiǎn)預(yù)防和控制不能提供針對(duì)居民個(gè)人的風(fēng)險(xiǎn)管理措施,新型農(nóng)村合作醫(yī)療和醫(yī)療救助只能滿足農(nóng)村居民最基本的醫(yī)療保障需求,在減輕農(nóng)村居民疾病經(jīng)濟(jì)負(fù)擔(dān)方面效果不甚理想；在社會(huì)層面,商業(yè)健康保險(xiǎn)在農(nóng)村發(fā)展緩慢,不能在農(nóng)村醫(yī)療保障體系中充分發(fā)揮作用,健康管理產(chǎn)業(yè)處于起步階段,不能提供全面、專(zhuān)業(yè)的健康管理服務(wù)；在居民個(gè)人和家庭層面,疾病風(fēng)險(xiǎn)管理整體缺失。第二,現(xiàn)行疾病風(fēng)險(xiǎn)管理模式存在諸多缺陷,比如疾病風(fēng)險(xiǎn)預(yù)防機(jī)制缺失,慢性病風(fēng)險(xiǎn)控制機(jī)制缺失,道德風(fēng)險(xiǎn)引起醫(yī)療費(fèi)用增加和衛(wèi)生資源浪費(fèi)等。第三,疾病風(fēng)險(xiǎn)日益復(fù)雜多樣,社會(huì)老齡化問(wèn)題凸顯,都對(duì)疾病風(fēng)險(xiǎn)管理提出了更高的要求。 針對(duì)現(xiàn)行疾病風(fēng)險(xiǎn)管理模式的缺陷和疾病風(fēng)險(xiǎn)管理現(xiàn)狀的不足,本文探索設(shè)計(jì)了農(nóng)村居民疾病風(fēng)險(xiǎn)管理新模式的框架。在該框架下,疾病風(fēng)險(xiǎn)管理體系涵蓋了疾病風(fēng)險(xiǎn)發(fā)生之前的疾病風(fēng)險(xiǎn)預(yù)防和疾病風(fēng)險(xiǎn)發(fā)生之后的疾病風(fēng)險(xiǎn)控制和補(bǔ)償。其中,在疾病風(fēng)險(xiǎn)預(yù)防和控制方面,引入“健康管理”,通過(guò)對(duì)人群的健康教育、行為干預(yù)以及慢性病的干預(yù)等措施,預(yù)防疾病發(fā)生,降低疾病風(fēng)險(xiǎn)損失概率和損失程度；在疾病風(fēng)險(xiǎn)補(bǔ)償方面,探討商業(yè)健康保險(xiǎn)和新型農(nóng)村合作醫(yī)療有效契合,提出了因病而異的疾病風(fēng)險(xiǎn)補(bǔ)償策略。最后,本文就新模式的推行提出了建議。
[Abstract]:This paper first evaluates the disease risk of rural residents in China, and evaluates the 16 kinds of major disease risks faced by rural residents in our country. The evaluation dimension includes the probability of loss of disease risk and the degree of loss of disease risk. The probability of loss is measured by disease specific two-week prevalence rate and disease specific chronic disease prevalence index, and the degree of loss is measured by disease economic burden index, in which, In this paper, the direct economic burden and indirect economic burden of 16 kinds of disease risk are calculated by using two-step model method and human capital issue, respectively. According to the results of the loss probability and degree of disease risk, the classification map of disease risk is drawn in this paper. The risk management requirements for each disease risk are analyzed by dividing 16 disease risks into five categories. Based on the results of disease risk assessment and the present situation of disease risk management, this paper expounds the necessity of exploring a new model of disease risk management for rural residents from three aspects. First, the supply of disease risk management is insufficient. At the government level, disease risk prevention and control can not provide individual risk management measures for residents, the new rural cooperative medical care and medical assistance can only meet the most basic medical security needs of rural residents. At the social level, the development of commercial health insurance in rural areas is slow, it can not play a full role in the rural medical security system, and the health management industry is in its infancy. Failure to provide comprehensive, professional health management services; overall absence of disease risk management at the individual and family levels. Second, there are many shortcomings in the current disease risk management model, such as the absence of disease risk prevention mechanisms. The lack of chronic disease risk control mechanism, the increase of medical expenses caused by moral hazard and the waste of health resources, etc. Third, disease risk is increasingly complex and diverse, and the problem of aging society is prominent, all of which put forward higher requirements for disease risk management. In view of the defects of the current disease risk management model and the deficiency of the present disease risk management, this paper explores and designs the framework of the new disease risk management model for rural residents. The disease risk management system covers disease risk prevention prior to disease risk and disease risk control and compensation after disease risk. Introducing "health management" to prevent the occurrence of disease and reduce the loss probability and degree of disease risk through the measures of health education, behavioral intervention and chronic disease intervention. This paper discusses the effective agreement between commercial health insurance and new rural cooperative medical system, and puts forward the disease risk compensation strategy which is different from illness. Finally, this paper puts forward some suggestions on the implementation of the new model.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：F842.684;F323.89;R193

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 盧建華;吳建國(guó);吳靜娜;王福影;徐文君;李星;;構(gòu)建適合中國(guó)國(guó)情的健康管理體系[J];中國(guó)全科醫(yī)學(xué);2009年03期

2 孫曉生;邢巖;;構(gòu)建中國(guó)特色的健康管理體系——“治未病”健康工程建設(shè)構(gòu)想[J];廣州中醫(yī)藥大學(xué)學(xué)報(bào);2010年05期

3 劉克軍,王梅;我國(guó)慢性病直接經(jīng)濟(jì)負(fù)擔(dān)研究[J];中國(guó)衛(wèi)生經(jīng)濟(jì);2005年10期

4 孫曉筠;Adrian Sleigh;Gordon Carmichael;李士雪;Sukhan Jackson;;新型農(nóng)村合作醫(yī)療保護(hù)農(nóng)民免于疾病經(jīng)濟(jì)風(fēng)險(xiǎn)評(píng)價(jià)方法[J];中國(guó)衛(wèi)生經(jīng)濟(jì);2007年01期

5 孫曉筠;Adrian Sleigh;李士雪;Gordon Carmichael;Sukhan Jackson;;新型農(nóng)村合作醫(yī)療保護(hù)農(nóng)民免于疾病經(jīng)濟(jì)風(fēng)險(xiǎn)效果評(píng)價(jià)[J];中國(guó)衛(wèi)生經(jīng)濟(jì);2007年02期

6 陶立波;楊莉;;農(nóng)村居民慢性病疾病經(jīng)濟(jì)負(fù)擔(dān)與風(fēng)險(xiǎn)研究[J];中國(guó)衛(wèi)生經(jīng)濟(jì);2007年11期

7 井珊珊;尹愛(ài)田;孟慶躍;劉曉云;嚴(yán)非;于保榮;;農(nóng)村居民慢性病患者衛(wèi)生服務(wù)利用的公平性研究[J];中國(guó)衛(wèi)生經(jīng)濟(jì);2010年02期

8 宿昆;王黎霞;陶韜;趙琦;徐飚;;四個(gè)山區(qū)縣肺結(jié)核患者疾病經(jīng)濟(jì)風(fēng)險(xiǎn)及其影響因素分析[J];中國(guó)衛(wèi)生經(jīng)濟(jì);2011年02期

9 張瑞利;;健康管理產(chǎn)業(yè)的供給現(xiàn)狀及趨勢(shì)分析[J];衛(wèi)生經(jīng)濟(jì)研究;2007年04期

10 趙紅征;;“健康管理”的必要性和可行性[J];衛(wèi)生經(jīng)濟(jì)研究;2009年08期

，

本文編號(hào)：1521471