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医疗费用个人负担一直是人们普遍关心的热点问题。在我国,城镇职工基本医疗保险制度采用费用分担方式,该机制的难点在于如何制定适当的费用分担比例。本研究采用蒙特卡洛模拟方法对不同起付线和不同报销比例下患者个人自付比例的变化进行模拟,以了解起付线和报销比例对个人自付比例的影响大小。并在此基础上模拟不同报销组合下,二、三级医院住院患者的个人自付比例情况。一、资料与方法(一)资料来源。资料来源于
The personal burden of medical expenses has always been a hot issue that people generally care about. In our country, the basic medical insurance system for urban workers adopts the cost-sharing method. The difficulty of this mechanism lies in how to formulate the appropriate proportion of the cost-sharing. In this study, the Monte Carlo simulation method was used to simulate the changes in patients ’personal copayments under different paylines and different reimbursement ratios in order to understand the impact of the proportion of paylines and reimbursement on the proportion of individuals’ copayments. And on this basis, simulate the different claims reimbursement combinations, second and third level hospital inpatient personal co-payment ratio. First, data and methods (a) sources. Data from