人口老龄化对福州市新型农村合作医疗住院基金影响的研究

发布时间：2018-02-27 06:28

本文关键词： 人口老龄化新型农村合作医疗住院基金　出处：《福建医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：人口老龄化对医疗卫生体系的冲击力度不可小觑，老年人口本身的医疗需求往往高于其他人群，老年人口的增加往往带动着医疗需求的增长。现有医疗保障体系能否平稳运行、保证基金不出险已成为制度设计者、制度执行者和参与者等多方关注的焦点。本研究旨在分析新农合运行情况、老年人住院费用特点，预测5年内老年人口数量和医疗服务需求、新农合基金偿付压力，为保障老年人医疗水平、新农合稳定发展提供客观依据。方法：本研究根据福州市新型农村合作医疗管理中心2009—2013年数据，运用定量分析与定性分析相结合的方法，使用描述性统计学方法对新农合基金运行情况进行分析，使用人口分要素预测方法、灰色模型预测方法对老年人口、新农合基金发展情况进行预测。同时，，采用访谈法了解各方对新农合应对老龄化的看法。结果：（1）福州市新农合运行平稳，参合率不断上升、筹资额稳步增长、基金收支基本平衡、补偿比例不断提高、农村居民的受益面和受益程度都得到了提升。（2）福州市新农合系统呈现年老型人口结构，老龄化趋势明显，老年人口住院服务利用不断增长，次均住院费用、人均住院费用不断升高；老年人口多倾向于非手术治疗，药品费用占比较大；多在乡级机构就医；其住院主要疾病集中在循环系统、呼吸系统、消化系统。（3）预测结果显示，未来5年后老年人口数量将增长至66.76万人，次均住院费用达12911元，住院基金筹资总额至少应达到17.85亿元，人均筹资额至少需536元。结论：新农合面临着老年人口增加、住院费用增长、政府筹资负担加重的挑战。建议加快医保并轨进程，明确补偿政策定位，扩大筹资渠道，促进患者分流，健全老年人口保障体系等。
[Abstract]:Objective: the impact of population aging on the health care system is not to be underestimated. The elderly population itself often has higher medical needs than other people. The increase in the elderly population often leads to an increase in the demand for medical care. Whether the existing medical security system can run smoothly and ensure that the fund does not risk has become the designer of the system. The purpose of this study is to analyze the operation of NCMS, the characteristics of hospitalization expenses of the elderly, the number of elderly population and the demand for medical services within 5 years, and the repayment pressure of NRCF. In order to ensure the medical level of the elderly, the stable development of NCMS provides an objective basis. Methods: according to the data of Fuzhou New Rural Cooperative Medical Management Center from 2009 to 2013, using the method of quantitative analysis and qualitative analysis, using descriptive statistical method to analyze the operation of New Rural Cooperative Medical Fund (NCMS). This paper uses the method of population sub-factor forecasting and grey model forecasting to forecast the development of the old population and the New Agricultural Cooperation Fund. At the same time, the author uses the interview method to find out the views of the new rural cooperation on how to cope with the aging. Results: 1) the operation of the new agricultural cooperation in Fuzhou was stable, the participation rate was constantly rising, the amount of funds raised steadily, the fund income and expenditure were basically balanced, and the proportion of compensation was constantly rising. The benefits and the degree of benefits of rural residents were improved. 2) the new rural cooperative system of Fuzhou showed an aging population structure, the trend of aging was obvious, the utilization of hospitalization services of the elderly population was increasing, and the average hospitalization cost. The per capita hospitalization costs are increasing; the elderly population tends to be non-surgical treatment, and the cost of drugs is relatively large; most of them seek medical treatment at the township level; the main inpatient diseases are concentrated in the circulatory system, respiratory system, digestive system, etc.) the predicted results show that, In the next five years, the number of the elderly population will increase to 667,600, the average hospitalization expenses will reach 12911 yuan, the total amount of funds raised by hospital funds should reach at least one billion seven hundred and eighty-five million yuan, and the amount of capital raised per capita should be at least 536 yuan. Conclusion: NCMS is faced with the challenge of increasing the elderly population, increasing hospital expenses and increasing the burden of government financing. It is suggested that the process of medical insurance should be accelerated, the position of compensation policy should be defined, the financing channel should be expanded, and the patient shunt should be promoted. Improve the security system for the elderly population.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F842.684;F323.89;R197.1;C924.24

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