家庭经济风险保护视角下中国城乡居民重大疾病风险因素及预测模型研究

全民健康覆盖（UHC）已成为全球卫生系统追求的共同目标。然而我国医疗保障改革在取得显著成就的同时，家庭经济风险保护形势依然严峻。研究发现，从家庭经济风险保护角度准确预测和识别重大疾病保障对象，并确定保障范围是突破该困境的关键。然而我国相关理论和实践均处于探索阶段。因此，本研究基于UHC和健康冲击机制，建立多维、公平的家庭经济风险测量方法。然后，以社会生态模型和健康冲击为理论基础，从家庭经济风险保护角度，运用结构方程模型构建重大疾病风险因素模型。在此基础上，通过BP神经网络建立风险预测模型。最后，提出完善我国重大疾病保障体系建议。家庭经济风险测量方法不仅从理论上完善疾病经济负担测量方法，而且能够支持不同保障政策围绕消除家庭经济风险目标进行衔接及其效果评价。重大疾病风险因素和预测模型不仅有利于全面理解重大疾病影响因素及其作用机制，而且能为我国重大疾病保障对象和范围的确定提供理论依据和实践方法。

Universal Health Coverage (UHC) has become a common goal of global health systems. Although China has achieved great success in medical security, family financial risk protection remains a big challenge. Defining target populations of catastrophic diseases and its security scope from the perspective of family financial risk protection is an essential step towards a breakthrough in the medical insurance reform. However, the development of relevant theories and practices is still in its infancy stage. Therefore, this study aims to develop a multi-dimensional and equitable model for measuring family financial risks associated with catastrophic diseases based on the frameworks of UHC and Health Shocks. Structural Equation Modeling will be adopted for the establishment of catastrophic disease determinant models guided by the theories of Social-Ecological Model and Health Shocks. A Back Propagation neural network will then be developed for risk forecasting of catastrophic diseases. Finally, recommendations in regard to improvement of the health security system for catastrophic diseases will be made. The innovative approach to the measurement of family financial risks associated with catastrophic diseases will not only contribute to the measurement of economic burden of diseases in theory, but also support a cohesive development and evaluation of health security policies with an aim to alleviate family financial risks. The catastrophic disease determinant models and risk forecasting models will help us to develop a better understanding about the impact of catastrophic diseases, and provide a theoretical basis and practical instrument for the determination of the target populations of catastrophic diseases and its security scope.