本文關(guān)鍵詞： 貧困人口 醫(yī)療救助 社會保障　出處：《山西財經(jīng)大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：近年伴隨居民就醫(yī)難、看病貴問題的愈演愈烈,外加醫(yī)療保險制度運行的道德風(fēng)險與逆向選擇行為,臨汾市經(jīng)濟(jì)發(fā)展水平的下行,低收入群體規(guī)模進(jìn)一步加大,亟需對其開展醫(yī)療保障工作以維護(hù)廣大居民尤其是貧困人口的基本醫(yī)療權(quán)益。醫(yī)療救助作為醫(yī)療保障領(lǐng)域的兜底性制度,也是我國一項基礎(chǔ)的社會救助工作,其建立與完善有利于縮小不同收入水平的居民在生活水平、醫(yī)療福利上的差距,體現(xiàn)發(fā)展為了人民的要求,為城鄉(xiāng)醫(yī)療救助對象的身體健康提供制度上的保障。本文對近年城鄉(xiāng)醫(yī)療救助政策進(jìn)行了梳理,就緩解貧困居民看病難、針對其開展醫(yī)療救助的文獻(xiàn)進(jìn)行了研究。并通過與臨汾民政部門、最低生活保障中心的合作,整理了臨汾醫(yī)療救助的文件與數(shù)據(jù),分析了醫(yī)療救助的實際效果,并借鑒了貼合臨汾實際的國內(nèi)外地區(qū)的救助發(fā)展經(jīng)驗。從醫(yī)療救助的供給方、需求方的角度反映了存在的問題主要是:醫(yī)療救助制度落實不到位、救助標(biāo)準(zhǔn)缺乏科學(xué)性;申請醫(yī)療救助的手續(xù)繁瑣;醫(yī)療資源配置失衡,救助資金投入動力不足,資金利用率偏低;尚未精準(zhǔn)識別存在醫(yī)療救助需求的貧困對象,存在“應(yīng)救未救”現(xiàn)象;“一站式”結(jié)算服務(wù)尚不成熟,引發(fā)過度醫(yī)療消費,救助工作的監(jiān)管仍不到位。造成臨汾醫(yī)療救助制度發(fā)展不甚理想的原因是多方位的,主要有城鄉(xiāng)醫(yī)療救助資源不足、救助理念滯后、政府主體作用式微、主管部門職能缺位、非政府部門參與受限等。結(jié)合對制度利益相關(guān)者的訪談,根據(jù)產(chǎn)生問題的制約因素提出的對策主要是:進(jìn)一步完善城鄉(xiāng)醫(yī)療救助制度,提高統(tǒng)籌層次,明確界定受助對象的資格條件,合理制定救助標(biāo)準(zhǔn);鼓勵慈善機構(gòu)和企業(yè)積極參與救助,利用私立醫(yī)療機構(gòu)床位空置率高的資源;政府充分發(fā)揮主體作用,加快對醫(yī)療機構(gòu)公益化運營的引導(dǎo),培養(yǎng)專業(yè)的救助服務(wù)人員,規(guī)范對醫(yī)療救助供需雙方的監(jiān)管;做好相關(guān)社會政策之間與醫(yī)療救助的銜接,促使一站式結(jié)算規(guī)范運營;加快形成醫(yī)前救助、預(yù)防保健的發(fā)展型救助理念,開展醫(yī)療救助領(lǐng)域的公私合作。鑒于醫(yī)療救助是完善多層次醫(yī)療保障制度的需要,應(yīng)不斷將政府、社會的工作重心轉(zhuǎn)移到此項民生工程上,以真正解決貧困人口看病難的問題,使窮人能夠病有所醫(yī)。
[Abstract]:In recent years, with the difficulty of medical treatment for residents, the growing problem of expensive medical treatment, and the moral hazard and adverse selection behavior in the operation of medical insurance system, the level of economic development in Linfen City has declined, and the scale of low-income groups has further increased. It is urgent to carry out medical security work to safeguard the basic medical rights and interests of the majority of residents, especially the poor. Medical assistance, as a bottomless system in the field of medical security, is also a basic social assistance work in China. Its establishment and improvement will help to narrow the gap between the living standards and medical benefits of residents with different income levels, and reflect the requirements of development for the people. This paper reviews the urban and rural medical assistance policies in recent years, and aims to alleviate the difficulties for poor residents to see a doctor. Through the cooperation with Linfen Civil Affairs Department and minimum living Security Center, the paper collates the documents and data of medical aid in Linfen, and analyzes the actual effect of medical aid. From the point of view of the supply side of medical aid, the demand-side reflects the existing problems: the implementation of medical aid system is not in place, and the aid standard is not scientific; The procedures for applying for medical assistance are cumbersome; the allocation of medical resources is out of balance; there is insufficient power to invest aid funds, and the utilization rate of funds is on the low side; the poor objects in need of medical assistance have not been accurately identified. There is the phenomenon of "should be saved and not saved", the "one-stop" settlement service is still immature, causing excessive medical consumption, and the supervision of relief work is still not in place. The reasons for the unsatisfactory development of the medical aid system in Linfen are multi-faceted. There are not enough medical aid resources in urban and rural areas, the concept of aid is lagging behind, the main role of the government is declining, the function of the competent department is absent, the participation of the non-governmental sector is restricted, etc. In combination with interviews with institutional stakeholders, According to the restrictive factors of the problems, the countermeasures are as follows: further perfecting the medical aid system in urban and rural areas, raising the overall planning level, clearly defining the eligibility conditions of the recipients, and rationally formulating the relief standards; To encourage charitable organizations and enterprises to take an active part in the rescue and to make use of the resources with high vacancy rates of beds in private medical institutions; the government should give full play to its main role, speed up the guidance to the public welfare operations of medical institutions, and train professional rescue service personnel. Standardizing the supervision of both sides of medical aid supply and demand; making a good connection between relevant social policies and medical assistance, promoting one-stop settlement standard operation; speeding up the formation of pre-medical assistance, preventive health care development relief concept, In view of the need to improve the multi-level medical security system, we should constantly shift the focus of the work of the government and society to this livelihood project in order to really solve the problem of the poor people's seeing a doctor. Make it possible for the poor to get sick.
【學(xué)位授予單位】：山西財經(jīng)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：D632.1;R197.1

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