遼寧省農(nóng)村大病保險(xiǎn)收支平衡問題研究
發(fā)布時(shí)間：2018-11-27 19:17
【摘要】：2012年8月30日,人社部、衛(wèi)生部、財(cái)政部等六部委聯(lián)合發(fā)布《關(guān)于開展城鄉(xiāng)居民大病保險(xiǎn)工作的指導(dǎo)意見》,對(duì)于新農(nóng)合參保人員和城鎮(zhèn)居民醫(yī)保大病負(fù)擔(dān)重的這一問題,引入市場機(jī)制,建立大病保險(xiǎn)制度,減輕城鄉(xiāng)居民的大病負(fù)擔(dān)。該制度是基本醫(yī)療保險(xiǎn)報(bào)銷后對(duì)城鎮(zhèn)居民醫(yī)保和新農(nóng)合參保人的“二次報(bào)銷”,制度的優(yōu)勢顯而易見,有力的緩解了許多大病患者的個(gè)人負(fù)擔(dān)。然而,在對(duì)大病保險(xiǎn)制度的研究中,更多的人將研究的目光聚焦在大病保險(xiǎn)的經(jīng)辦模式選擇以及國外醫(yī)療保險(xiǎn)制度的借鑒上,缺乏根據(jù)我國實(shí)際情況因地制宜的實(shí)證研究,特別是未來大病醫(yī)療保險(xiǎn)基金收支的平衡問題,這一問題將關(guān)系到制度能否真正持續(xù)的運(yùn)行下去。遼寧省是在全國范圍內(nèi)率先開展大病保險(xiǎn)業(yè)務(wù)的地區(qū)之一。2013年3月,遼寧省農(nóng)村居民大病保險(xiǎn)業(yè)務(wù)試點(diǎn)工作開始正式啟動(dòng),由于農(nóng)村的經(jīng)濟(jì)發(fā)展水平、醫(yī)療水平、人均可支配收入低于城市,致使農(nóng)村居民在面臨大病風(fēng)險(xiǎn)支出時(shí)更加脆弱,因病致貧、因貧返貧的問題更容易發(fā)生。同時(shí),從制度實(shí)際運(yùn)行來看,遼寧省農(nóng)村大病保險(xiǎn)有著救治大病患者數(shù)量多、支出大的特點(diǎn)。2016年全省農(nóng)村居民大病保險(xiǎn)共補(bǔ)償新農(nóng)合患者10.59萬人次,大病保險(xiǎn)補(bǔ)償支出4.67億元,在這樣的背景下,遼寧省農(nóng)村未來的大病保險(xiǎn)收支很難平衡,收不抵支的基金將難以為繼,制度實(shí)施的可持續(xù)性也將不能得到保障,對(duì)遼寧省未來農(nóng)村大病保險(xiǎn)的收支測算十分必要,以達(dá)到大病保險(xiǎn)制度動(dòng)態(tài)調(diào)整的目標(biāo),應(yīng)對(duì)基金風(fēng)險(xiǎn)與挑戰(zhàn),從而更好的滿足遼寧省農(nóng)村居民的醫(yī)療保障需求水平。本文主要包括五個(gè)部分的內(nèi)容:第一部分為相關(guān)概念界定與理論基礎(chǔ),對(duì)大病及大病保險(xiǎn)的相關(guān)概念進(jìn)行界定,同時(shí),選取相關(guān)理論作為本文研究的理論基礎(chǔ);第二部分為遼寧省農(nóng)村大病保險(xiǎn)的實(shí)施現(xiàn)狀與問題,論述遼寧省農(nóng)村大病保險(xiǎn)制度當(dāng)前的實(shí)施情況,探討了與遼寧省農(nóng)村大病保險(xiǎn)收支的相關(guān)問題;第三部分為遼寧省農(nóng)村大病保險(xiǎn)收支平衡影響因素的實(shí)證分析,探尋影響遼寧省農(nóng)村大病保險(xiǎn)基金收支的因素,運(yùn)用主成分分析法對(duì)各項(xiàng)指標(biāo)進(jìn)行分析,找出影響的主要因素進(jìn)行重點(diǎn)分析;第四部分為遼寧省農(nóng)村大病保險(xiǎn)基金收支測算,分別設(shè)立大病保險(xiǎn)基金收入與支出模型,考察大病保險(xiǎn)未來的收支情況。通過預(yù)測未來遼寧省新農(nóng)合基金的收支情況,考察新農(nóng)合基金是否有進(jìn)行大病保險(xiǎn)補(bǔ)償支出的能力以及引入大病保險(xiǎn)制度對(duì)新農(nóng)合基金有何種影響;第六部分為結(jié)論及對(duì)策建議,根據(jù)本文研究得出結(jié)論并做出說明,提出實(shí)現(xiàn)遼寧省大病保險(xiǎn)收支平衡問題的對(duì)策及建議。
[Abstract]:On August 30, 2012, the Ministry of people's and Social Affairs, the Ministry of Health, the Ministry of Finance, and other six ministries jointly issued the guiding opinions on the Development of serious illness Insurance for Urban and Rural residents, which is an issue of heavy medical care burden for new rural co-operative insurance workers and urban residents. Introduce market mechanism, establish a serious illness insurance system, reduce the burden of serious illness of urban and rural residents. This system is the "second reimbursement" of the urban residents' medical insurance and the new rural cooperative insured after the reimbursement of basic medical insurance. The advantages of the system are obvious, which can alleviate the personal burden of many seriously ill patients. However, in the study of the serious illness insurance system, more people focus their attention on the choice of the management mode of the serious illness insurance and the reference of the foreign medical insurance system, and lack of empirical research according to the actual situation of our country. Especially the problem of balance of income and expenditure of medical insurance fund for serious illness in the future, this problem will affect whether the system can really continue to run. Liaoning Province is one of the first regions in the country to carry out serious illness insurance business. In March 2013, the pilot work of serious illness insurance for rural residents in Liaoning Province began to be officially started. Due to the level of economic development in rural areas, the level of medical treatment, The per capita disposable income is lower than that in urban areas, which makes rural residents more vulnerable when they face the risk of serious illness. At the same time, from the point of view of the actual operation of the system, Liaoning Province's rural serious illness insurance has the characteristics of large number of patients who are seriously ill and large expenditure. In 2016, the rural residents' serious illness insurance of the whole province compensated 105900 new rural cooperative patients. Under such a background, it is very difficult to balance the income and expenditure of the rural areas of Liaoning Province in the future of serious illness insurance, and the funds that receive or not offset will be difficult to sustain, and the sustainability of the implementation of the system will also not be guaranteed. It is necessary to measure the income and expenditure of Liaoning Province's future rural serious illness insurance, in order to achieve the goal of dynamic adjustment of the serious illness insurance system, to deal with the fund risks and challenges, so as to better meet the level of medical security needs of rural residents in Liaoning Province. This paper mainly includes five parts: the first part is the definition of related concepts and theoretical basis, the definition of serious illness and serious illness insurance related concepts, at the same time, select the relevant theory as the theoretical basis of this study; The second part is about the status quo and problems of rural serious illness insurance in Liaoning Province, discusses the current implementation of Liaoning Province rural serious illness insurance system, and discusses the related issues related to the income and expenditure of Liaoning Province rural serious illness insurance. The third part is the empirical analysis of the factors affecting the balance of income and expenditure of the rural major illness insurance in Liaoning Province, and explores the factors that affect the income and expenditure of the insurance fund of the rural major illness in Liaoning Province. The principal component analysis method is used to analyze the various indicators. Find out the main factors affecting the analysis; The fourth part is the calculation of the income and expenditure of the rural serious illness insurance fund in Liaoning Province. The model of income and expenditure of the serious illness insurance fund is set up to investigate the future income and expenditure of the serious illness insurance. Through forecasting the income and expenditure of the new rural cooperative fund in Liaoning province, this paper investigates whether the new rural cooperative fund has the ability to compensate the expenditure of the serious illness insurance and what influence the introduction of the serious illness insurance system has on the new rural cooperative fund. The sixth part is the conclusion and the countermeasure suggestion, according to the research conclusion and the explanation, puts forward the countermeasure and the suggestion to realize the Liaoning Province serious illness insurance income and expenditure balance problem.
【學(xué)位授予單位】：遼寧大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：F842.684;F323.89
本文編號(hào)：2361779
[Abstract]:On August 30, 2012, the Ministry of people's and Social Affairs, the Ministry of Health, the Ministry of Finance, and other six ministries jointly issued the guiding opinions on the Development of serious illness Insurance for Urban and Rural residents, which is an issue of heavy medical care burden for new rural co-operative insurance workers and urban residents. Introduce market mechanism, establish a serious illness insurance system, reduce the burden of serious illness of urban and rural residents. This system is the "second reimbursement" of the urban residents' medical insurance and the new rural cooperative insured after the reimbursement of basic medical insurance. The advantages of the system are obvious, which can alleviate the personal burden of many seriously ill patients. However, in the study of the serious illness insurance system, more people focus their attention on the choice of the management mode of the serious illness insurance and the reference of the foreign medical insurance system, and lack of empirical research according to the actual situation of our country. Especially the problem of balance of income and expenditure of medical insurance fund for serious illness in the future, this problem will affect whether the system can really continue to run. Liaoning Province is one of the first regions in the country to carry out serious illness insurance business. In March 2013, the pilot work of serious illness insurance for rural residents in Liaoning Province began to be officially started. Due to the level of economic development in rural areas, the level of medical treatment, The per capita disposable income is lower than that in urban areas, which makes rural residents more vulnerable when they face the risk of serious illness. At the same time, from the point of view of the actual operation of the system, Liaoning Province's rural serious illness insurance has the characteristics of large number of patients who are seriously ill and large expenditure. In 2016, the rural residents' serious illness insurance of the whole province compensated 105900 new rural cooperative patients. Under such a background, it is very difficult to balance the income and expenditure of the rural areas of Liaoning Province in the future of serious illness insurance, and the funds that receive or not offset will be difficult to sustain, and the sustainability of the implementation of the system will also not be guaranteed. It is necessary to measure the income and expenditure of Liaoning Province's future rural serious illness insurance, in order to achieve the goal of dynamic adjustment of the serious illness insurance system, to deal with the fund risks and challenges, so as to better meet the level of medical security needs of rural residents in Liaoning Province. This paper mainly includes five parts: the first part is the definition of related concepts and theoretical basis, the definition of serious illness and serious illness insurance related concepts, at the same time, select the relevant theory as the theoretical basis of this study; The second part is about the status quo and problems of rural serious illness insurance in Liaoning Province, discusses the current implementation of Liaoning Province rural serious illness insurance system, and discusses the related issues related to the income and expenditure of Liaoning Province rural serious illness insurance. The third part is the empirical analysis of the factors affecting the balance of income and expenditure of the rural major illness insurance in Liaoning Province, and explores the factors that affect the income and expenditure of the insurance fund of the rural major illness in Liaoning Province. The principal component analysis method is used to analyze the various indicators. Find out the main factors affecting the analysis; The fourth part is the calculation of the income and expenditure of the rural serious illness insurance fund in Liaoning Province. The model of income and expenditure of the serious illness insurance fund is set up to investigate the future income and expenditure of the serious illness insurance. Through forecasting the income and expenditure of the new rural cooperative fund in Liaoning province, this paper investigates whether the new rural cooperative fund has the ability to compensate the expenditure of the serious illness insurance and what influence the introduction of the serious illness insurance system has on the new rural cooperative fund. The sixth part is the conclusion and the countermeasure suggestion, according to the research conclusion and the explanation, puts forward the countermeasure and the suggestion to realize the Liaoning Province serious illness insurance income and expenditure balance problem.
【學(xué)位授予單位】：遼寧大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：F842.684;F323.89
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 朱銘來;宋占軍;;大病保險(xiǎn)試點(diǎn)周年評(píng)述[J];中國醫(yī)院院長;2014年03期
2 丁少群;許志濤;薄覽;;社會(huì)醫(yī)療保險(xiǎn)與商業(yè)保險(xiǎn)合作的模式選擇與機(jī)制設(shè)計(jì)[J];保險(xiǎn)研究;2013年12期
3 羅雪燕;徐偉;;江蘇省城鎮(zhèn)基本醫(yī)療保險(xiǎn)補(bǔ)償水平評(píng)價(jià)[J];中國衛(wèi)生經(jīng)濟(jì);2013年12期
4 吳維民;楊秀玲;蔣帥;范麗;韋波;;利用基本醫(yī)保結(jié)余建立大病保險(xiǎn)基金的研究[J];衛(wèi)生經(jīng)濟(jì)研究;2013年08期
5 周競;管士云;羅玉霞;;大病補(bǔ)充醫(yī)療保險(xiǎn)的理論基礎(chǔ)與國際經(jīng)驗(yàn)研究[J];知識(shí)經(jīng)濟(jì);2013年13期
6 鄭秉文;張興文;;一個(gè)具有生命力的制度創(chuàng)新:大病保險(xiǎn)“太倉模式”分析[J];行政管理改革;2013年06期
7 朱銘來;于新亮;宋占軍;;我國城鄉(xiāng)居民大病醫(yī)療費(fèi)用預(yù)測與保險(xiǎn)基金支付能力評(píng)估[J];保險(xiǎn)研究;2013年05期
8 董曙輝;;關(guān)于大病保險(xiǎn)籌資與保障范圍的思考[J];中國醫(yī)療保險(xiǎn);2013年04期
9 卞呈祥;俞彤;;城鄉(xiāng)居民大病保險(xiǎn)經(jīng)辦運(yùn)行機(jī)制探討——以廈門為例[J];衛(wèi)生經(jīng)濟(jì)研究;2013年04期
10 徐善長;;大病保險(xiǎn):健全醫(yī)保體系的重要環(huán)節(jié)[J];宏觀經(jīng)濟(jì)管理;2013年03期
相關(guān)碩士學(xué)位論文 前9條
1 楊丹琳;寧夏城鄉(xiāng)居民大病保險(xiǎn)測算研究[D];寧夏醫(yī)科大學(xué);2015年
2 王志遠(yuǎn);城鄉(xiāng)居民大病保險(xiǎn)基金承受能力影響因素分析[D];東北財(cái)經(jīng)大學(xué);2014年
3 郝璐頤;新農(nóng)合大病保險(xiǎn)風(fēng)險(xiǎn)分析與控制[D];山東大學(xué);2014年
4 潘賽;構(gòu)建城鄉(xiāng)居民大病保險(xiǎn)良性機(jī)制研究[D];湖南師范大學(xué);2014年
5 段會(huì)晴;保險(xiǎn)公司承辦城鄉(xiāng)居民大病保險(xiǎn)運(yùn)行中的主要問題及建議研究[D];西南財(cái)經(jīng)大學(xué);2014年
6 周競;商業(yè)保險(xiǎn)機(jī)構(gòu)經(jīng)辦大病保險(xiǎn)的可持續(xù)研究[D];貴州財(cái)經(jīng)大學(xué);2014年
7 劉霄;大病保險(xiǎn)“費(fèi)用模式”費(fèi)率研究[D];華東師范大學(xué);2013年
8 楊艷;成都市大病醫(yī)療互助補(bǔ)充保險(xiǎn)委托保險(xiǎn)公司經(jīng)辦模式選擇及實(shí)施過程研究[D];西南財(cái)經(jīng)大學(xué);2012年
9 李俊;商業(yè)保險(xiǎn)公司參與社會(huì)醫(yī)療保險(xiǎn)管理的模式研究[D];西南財(cái)經(jīng)大學(xué);2012年
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