文章基于对河北省霸州市、湖北省赤壁市和重庆市合川区三个县级行政区域城镇贫困居民的抽样调查，考察了城镇医疗保障制度降低贫困居民就医经济负担的效果。研究结果表明，城镇居民基本医疗保险和医疗救助的实施在一定程度上减轻了贫困居民的就医经济负担，但由于城镇医疗保障制度实际报销比例偏低、贫困居民对医疗费用的承担能力有限以及大量贫困居民存在灾难性医疗支出，他们的就医经济负担仍然较重；在住院治疗中，降低城镇居民基本医疗保险和医疗救助的起付线、提高报销比例、简化报销程序等措施能够有效降低城镇贫困居民的就医经济负担。%Based on a sample survey of urban poor households in Bazhou in Hebei province, Chibi in Hubei province and Hechuan in Chongqing, this paper examines the effect of the urban medical security system on reducing the economic burden of access to health care on the urban poor. It demon- strates that the implementation of the urban resident basic medical insurance (URBMI)and medical assistance (MA) reduces the economic burden of ac- cess to health care on the urban poor to a certain extent. However, owing to a small proportion of actual reimbursement to total healthcare expenditure in the urban medical security system, limited medical expenses affordability and catastrophic medical expenses of a large number of the poor residents, the economic burden of access to health care on the urban poor is still heavy. In terms of patient treatment, such measures as the decrease in the pay line in the urban resident basic medical insurance and medical assistance, the rise in the proportion of actual reimbursement to total healthcare expenditure and the facilitation of reimbursement procedures, can effectively reduce the eco- nomic burden of access to health care on the urban poor.
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