【作者】 李琦；

【导师】 王保真；

【作者基本信息】 武汉大学 ， 社会医学与卫生事业管理， 2005， 硕士

【摘要】 20世纪90年代中后期,我国城市贫困问题逐步显露。卫生服务过度市场化,一些卫生服务机构和单位偏离其维护人群健康的宗旨,医疗费用快速增长,医疗保障制度不完善,低收入人群的基本健康无法得到保障。为了完善最低生活保障制度、促进医疗保险制度改革、维持社会稳定、实现社会公平,我国城市应当建立和完善医疗救助制度。 本文首先分析了经济转轨时期我国建立城市居民医疗救助的背景。其次主要从6大区12个城市已经实施的医疗救助方案中,总结、分析出我国城市居民医疗救助的基本情况、个别城市突出的特点、存在的主要问题及其原因,重点涉及医疗救助规章建立的情况、医疗救助对象、方式、内容、标准、资金来源和管理机构等几个方面。然后介绍中英城市社区卫生服务与贫困救助项目中相关方面的基本情况,说明了该项目对建立和完善我国城市居民医疗救助的启示。最后结合贫困理论、公共财政理论等相关依据提出完善我国城市居民医疗救助的政策建议,包括尽快制定专门法律,确保医疗救助顺利实施;城市所有需要或者可能需要医疗救助的居民应纳入医疗救助体系;对不同低收入人群采取不同的保障内容,注重卫生保健,预防接种,基本门诊服务;对不同医疗救助对象实行不同的医疗救助方式;采取多种渠道筹资集医疗救助基金,提高救助标准;医疗救助应作为公共财政转移支付的优先项目;实行民政管理为主,多部门协同合作的医疗救助管理体制等。更多还原

【Abstract】 From the middle and late 1990s, poverty problem in cities of our country has been progressively arising. Health service is over marketed; some health service institutions and units deviate from their aims of maintaining the human being’s health; Medical expenditure is rapidly increasing; Medical Security system is not well perfect and basic health for the poor can not be guaranteed. The Medical Assistance system should be established and perfected in our cities so as to consummate the lowest living standard security System, boost the reform of Basic Medical Insurance system, maintain the social stability and bring the social equality to reality.This thesis firstly analyzed the background under which our country established the Medical Assistance for the urban residents in the economic transition. And then it summarized the basic situations of medical assistance for citizens, prominent features of individual cities as well as its existing main concerns, mainly involving circumstances of regulation building in Medical Assistance and its targets, ways, contents standards and financing and management organization etc. from the Medical Assistance schemes carried out in 12 cities of 6 big regions. And next it revealed the inspiration China-UK Health Poverty Project(UHPP) brought for the perfection and establishment of resident’s Medical Assistance by introducing its relevant basic situations. Finally it brought up policies and proposals for perfecting the urban residents’ Medical Assistance via the combination of poverty theory, public finance theory, health poverty theory and other related theories. The policies and proposals included: making special laws as soon as possible so as to ensure the smooth enforcement of medical assistance; all the residents needing or may needing medical assistance should be involved in the medical assistance system; the security contents should vary according to different low income groups, emphasizing their health cares, inoculation and the fundamental out-patient services as well; ways of medical assistance should also change in accordance with different targets of medical assistance; raising medical assistance funds through a variety of channels for purpose of the improvement of the assistance standard; Medical assistance should be viewed as the preferred project of the public finance transfer payment; enforcing the Medical Assistance management system largely by civil administration along with multi-department’s collaborative cooperation.更多还原