Analyze compensation patterns and compensation effects of catastrophic disease insurance in L City / 中国卫生政策研究

ABSTRACT

Objective:This paper designs to analyze compensation patterns and compensation effects of cata-strophic disease insurance in L City, and put forward feasible suggestions to improve the compensation patterns of cat-astrophic disease insurance. Methods:We combined the relevant policy documents to analyze compensation patterns, and used benefit rate, OOP and The effective reimbursement rate to analyze compensation effects of catastrophic dis-ease insurance. Results:Catastrophic disease insurance benefit rate in L city in 2013 was 3. 2%; Rates of NCMS fund unilization was 92%, which diversed from county to county. Patients' OOP decreased significantly after reim-bursement of catastrophic disease insurance;Catastrophic disease insurance and NCMS total effective reimbursement rate reached 84.8%;The NCMS compensation rate reached 68. 9%, while fund incurred a financial deficit at the same time. Conclusion:Set deductibles, compensation rate and compensation range scientifically, and cancel ceiling level,improve the program of catastrophic disease insurance. Take measures to reduce the unfair between the districts and counties at city level. Establish effective link-up between catastrophic disease insurance and NCMS.