擴大脆弱人群健康保險覆蓋率的策略：描述性系統評價_《中國循證醫學雜志》

作者：

袁蓓蓓 ¹ , 賈莉英 ¹ , 王健 ¹ , 于保榮 ¹ , 高軍 ² , PaulGarner ³ ,  孟慶躍 ¹

1. 山東大學衛生管理與政策研究中心（濟南 250012）; 2. 衛生部統計信息中心（北京 100044）; 3. Liverpool School of Tropical Medicine, Liverpool, UK;

關鍵詞：

健康保險覆蓋脆弱人群系統評價

DOI：

10.7507/1672-2531.20080170

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　描述擴大脆弱人群健康保險覆蓋率的策略及作者對實施這些策略的評價。
方法　由主題專家和檢索人員討論并試驗后確定檢索詞，共檢索28 個電子數據庫、12 個衛生機構網站、3 個灰色文獻數據庫和搜索引擎Google。納入所有描述或評價已經實施的擴大脆弱人群健康保險覆蓋率策略的文獻。用預先設計的數據提取表收集文獻內容和有關研究質量的信息，分析和描述提取信息。
結果　共納入86 篇文獻，大多研究來自美國，主要研究人群是兒童。61 篇描述策略，25 篇評價策略。據衛生籌資機制理論分析，擴大健康保險的策略分為六類，即改變健康保險的入保資格、提高對健康保險的認知度、合理設置保險金水平、改進入保程序、改善衛生服務提供、改善保險的管理和組織。評價策略的研究大部分為回顧性縱向數據分析，僅有兩篇為隨機對照試驗。評價研究的結論是所實施的策略對擴大保險覆蓋有正面效應。
結論　美國等發達國家已實施大量策略用于擴大健康保險覆蓋率，發展中國家實施的策略和相關研究均較少，發達國家實施的策略對發展中國家有一定的借鑒意義。納入文獻中有25 篇評價策略效果的研究，可做進一步的系統評價，以考察策略對擴大健康保險覆蓋率的效果。

引用本文： 袁蓓蓓,賈莉英,王健,于保榮,高軍,PaulGarner,孟慶躍. 擴大脆弱人群健康保險覆蓋率的策略：描述性系統評價. 中國循證醫學雜志, 2008, 08(9): 744-756. doi: 10.7507/1672-2531.20080170 復制

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7. De Allegri M, Sanon M, Bridges J, et al. Understanding consumers’ preferences and decision to enroll in community-based health insurance in rural West Africa. Health Policy, 2006, 76(1): 58-71.
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擴大脆弱人群健康保險覆蓋率的策略：描述性系統評價

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