湖南某县2010—2012年参合农民就诊及补偿的实证研究

发布时间：2018-03-02 06:41

本文关键词： 新型农村合作医疗补偿疾病谱湖南　出处：《中国卫生经济》2014年05期 　论文类型：期刊论文

【摘要】：目的:从该县的实际情况以及所面临的问题出发,为该县未来新型农村合作医疗政策进行有针对性的调整提供依据。方法:主要利用现场调研的方法收集所需数据,并利用数理统计分析的方法对数据进行描述和分析。结果:2012年该县新型农村合作医疗参合率已达到99.2%,住院人次快速增长,平均住院日基本保持平稳,平均住院费用有明显上涨,参合农民的自付费用逐年增加,自付费用占收入的比例并没有明显下降,各类医疗机构的补偿比例逐年提升,参合农民住院诊断前10位病种3年变化不大,肺部感染居首位。结论:该县新农合基本实现农业人口的全覆盖;仍需调整政策,降低自付费用占人均纯收入的比例;另外,在扩大新农合的病种报销范围的同时,要实施小病分类补偿,优化小病统筹的效率,充分发挥基层医疗机构的优势;多方面着手,以切实提高农民的受益程度,完善新农合政策。
[Abstract]:Objective: to provide the basis for the adjustment of the new rural cooperative medical policy in the future from the actual situation and the problems faced by the county. Methods: the method of field investigation was mainly used to collect the needed data. The data were described and analyzed by means of mathematical statistics. Results: in 2012, the participation rate of the new rural cooperative medical system in this county had reached 99.2, the number of hospitalizations increased rapidly, the average hospitalization days remained stable, and the average hospital expenses increased obviously. The out-of-pocket expenses of participating farmers increased year by year, the proportion of out-of-pocket expenses to income did not decrease obviously, the proportion of compensation of various kinds of medical institutions increased year by year, and there was little change in the first 10 diseases of participating farmers in hospital for 3 years. Conclusion: it is necessary to adjust the policy to reduce the proportion of out-of-pocket expenses to the per capita net income. In addition, while expanding the reimbursement range of NCMS, it is necessary to reduce the proportion of self-paid expenses to the per capita net income. It is necessary to implement the classification compensation for minor diseases, optimize the efficiency of coordinating minor diseases, give full play to the advantages of primary medical institutions, and carry out various measures to improve the benefit degree of farmers and improve the new rural cooperative policy.
【作者单位】：首都医科大学公共卫生学院;首都师范大学医院内科;中国医学科学院医学信息研究所;
【基金】：联合国儿童基金会项目(YH702-1.1.15)
【分类号】：R197.1;F842.684;F323.89

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