【摘要】 目的通过对比医保整合地区与非整合地区居民住院费报销比例的差异,并结合专家对医保整合效果评价,分析医保整合对城乡之间住院费报销差距的影响。方法数据来源于第五次卫生服务调查,抽取170位专家作为本研究的调查对象,对其进行问卷调查,运用一般性描述分析对医保整合实施情况进行分析。结果医保整合地区居民住院直接医疗费用报销比例城乡差距低于非医保整合地区,医保整合地区为0.43%,非医保整合地区为2.03%。有58.2%的专家认为医保整合改善了城乡参保人群待遇不公问题,有74.12%专家认为整合后缓解了制度分割的现象。结论实施医保整合对缩小城乡之间住院费报销差距方面起到一定的作用,但医保整合的具体实施情况还要进一步完善。更多还原

【Abstract】 Objective To analyze the impact of medical insurance integration on the gap between urban and rural hospitalization reimbursement by comparing the hospitalization security treatment of residents in integrated and non-integrated areas, and combining the experts’ evaluation of medical insurance integration effect. Methods Data from the fifth health service survey were collected, and 170 experts were selected by convenient sampling method. Questionnaire survey was conducted, and descriptive analysis was used to analyze the implementation of medical insurance integration. Result The ratio of reimbursement for direct medical expenses in residents of integrated medical insurance area is lower than that of non-integrated medical insurance area. The ratio of reimbursement in integrated medical insurance area is 0.43% and that in non-integrated medical insurance area is 2.03%. 58.2% of experts believe that the integration of medical insurance has reduced the inequality of treatment of urban and ruralinsured population, and 74.12% believe that the integration has alleviated the phenomenon of institutional segmentation. Conclusion The implementation of medical insurance integration plays a certain role in narrowing the gap between urban and rural hospitalization reimbursement, but the specific implementation of medical insurance integration needs to be further improved.更多还原