【摘要】 通过武汉市近 3年住院医疗服务及实际医疗费用的支出分析 ,对即将启动的武汉市城市职工基本医疗保险基金 ,统筹基金的测算 ,认为 :基金筹资水平在单位征缴 7%的基础上 ,社会统筹基金的分配比例 ,可控制在用人单位缴费的 5 2 %～ 5 5 %之间。起付线可控制在城市职工 3年年平均工资的 8%～ 10 %左右 ,即 5 0 0～ 6 40元之间。最高支付限额控制在职工年平均工资的 4倍左右 ,即 2 5 5 0 0～ 30 0 0 0元之间。医疗费用偿付方式 ,在医疗保险改革初期 ,可采用按每人平均住院天数 ,平均每日费用 ,并结合不同等级医院按不同标准给予偿付结算。更多还原

【Abstract】 Analyzes the actually fee of medical service for in patients last three years in Wuhan area, also researches into the coming reform of the Wuhan employee basic insurance fund, as well as the social unified raising. In accordance with such research, we suggest that the unit which the employee works in should take out 7% of the basic fund, and the actually fee must be limited from 52% to 55% of the total fund. The first deduction could be around 8%~10% of the average year salary of the employee in last three years, about RMB 500 Yuan to RMB640 Yuan. Meanwhile, the max sum of the deduction might around four times of the year total salary of the employee, about RMB 25 500 yuan to RMB 30000 Yuan. On the first stage of the healthy insurance reform, the medical fee could base on the average days live in hospital, average day fee and hospital rank.\;更多还原