农村居民大病保险经济补偿能力及效果

经济补偿是农村居民大病保险的基本职责，经济补偿能力是履行该职责的前提和基础，经济补偿效果是履行该职责的具体体现。利用江苏省5个样本地区的实地调研数据，从横向和纵向两个维度评估了各地大病保险的经济补偿能力，从大病保险的受益面、患者个人自付比例、大病保险基金使用率等指标综合衡量各地大病保险的经济补偿效果。研究发现，医疗费用、筹资机制、政策设计等多种主客观因素共同约束着大病保险经济补偿能力和补偿效果的发挥，亟需从补偿主体的衔接、大病费用的控制、筹资机制的建设、大病保险的服务等方面进行改进。

Research on Economic Compensation Ability and Compensation Effect of Critical Illness Insurance of Rural Residents

Economic compensation is the basic duty of critical illness insurance of rural residents, and economic compensation ability is the premise and basis to perform the duty, while economic compensation effect is a concrete manifestation of the duty. Based on the research data of five sample areas in Jiangsu Province, this paper assesses the economic compensation ability of critical illness insurance from both horizontal and vertical dimensions systematically, and uses benefit rate, OOP, rates of critical illness insurance fund utilization to measure the economic compensation effect synthetically. The results show that a variety of subjective and objective factors of medical cost, financing mechanisms, and policy design factors, which together constrain the economic compensation ability and compensation effect of critical illness insurance. Finally, the paper puts forward some suggestions to improve the situation, including adjusting the cohesion of compensation body, controlling the cost of critical illness, constructing the financing mechanisms, and optimizing critical illness insurance service.