泰国30铢医疗计划及对中国新农合的启示

发布时间：2018-03-15 16:54

本文选题：泰国30铢医疗计划　切入点：新型农村合作医疗制度　出处：《山东大学》2013年硕士论文　论文类型：学位论文

【摘要】：泰国总人口6400万,农村人口约占70%。泰国和中国都是发展中国家,两国在经济发展水平和人口结构方面有很多相似之处。泰国在2001年建立起了全民医疗保险制度,其中的30铢医疗计划就覆盖了全国75%的人口,其中农民占70%(张禄生等,2009)。泰国通过30铢医疗计划实现了人人享有医疗保障的目标,该政策对中国的医疗保险改革有借鉴和启示作用。中国农村实行的是新型农村合作医疗制度，，经过了多年的实施和改革,已经覆盖了大部分的农村人口。作为医疗保险的一个重要的组成部分,新农合制度面临着巨大的挑战,新农合已经成为中国医疗改革的重点,是当今中国政府和社会最为关注的问题之一。完善新农合制度,实现政策的可持续发展,不仅是中国农村社会医疗保险事业发展的迫切需要,更直接关系到中国改革、发展、稳定的大局,影响到经济的发展以及社会的稳定与和谐。本文通过综合分析泰国30铢医疗计划的实施背景、条件、具体措施、影响等,并对比泰国30铢医疗计划和中国新农合制度,借鉴泰国30铢医疗计划的成功经验,结合中国具体国情,对新农合制度的进一步改革与完善提出建议,同时总结泰国30铢医疗计划在推行过程中出现的问题和走过的弯路,以免在中国新农合制度改革与实践中重蹈覆辙。本文主要分为五个部分：第一部分,绪论,涉及选题缘起和选题意义、国内外文献综述、理论背景、概念界定和研究方法；第二部分,主要介绍泰国30铢医疗计划的实施背景、条件及举措。包括30铢医疗计划实施前的医疗服务机构情况,医疗保险情况,实施的有利条件,泰国政府在实施30铢医疗计划过程中的举措；第三部分,30铢医疗计划的实际运行状况及影响；第四部分,从各个方面将泰国30铢医疗计划和中国的新农合进行对比,吸取经验,总结教训。笔者在泰国素叻塔尼市选择了20位访谈对象,利用个案访谈的方法收集定性资料,访谈内容主要包括访谈对象对于30铢医疗计划的了解程度、参与程度、利用度和满意度等几个方面,并将所收集资料进行定性分析,以期了解30铢医疗计划的具体实施情况,实施过程中政策的变动情况以及服务对象对该政策的回馈；第五部分,通过对30铢医疗计划的分析,结合中国新农合目前的具体问题,对完善新农合制度提出对策建议。泰国30铢医疗计划对中国新农合制度有重要的借鉴作用,新农合应从降低成本入手,规范药品目录,改革支付方式控制医疗费用,并在此基础上进一步加大财政投入逐步提高保障水平。
[Abstract]:Thailand has a total population of 64 million and rural population accounts for about 70 percent. Both Thailand and China are developing countries, and there are many similarities between the two countries in terms of economic development level and population structure. In 2001, Thailand established a universal medical insurance system. The 30-baht medical plan covers 75% of the country's population, of which 70 are farmers. (Zhang Lusheng, et al.) Thailand has achieved the goal of universal access to health care through the 30-baht medical plan. The policy can be used for reference and enlightenments in China's medical insurance reform. China's rural areas have implemented a new type of rural cooperative medical care system, which has been implemented and reformed for many years. It has covered most of the rural population. As an important part of medical insurance, the new rural cooperative cooperation system is facing enormous challenges, and the new rural cooperative cooperation has become the focus of China's health care reform. It is one of the issues that the Chinese government and society are most concerned about. Perfecting the new agricultural cooperation system and realizing the sustainable development of policies are not only the urgent needs of the development of China's rural social medical insurance, but also have a direct bearing on the reform and development of China. Stable overall situation, affect the economic development and social stability and harmony. Through comprehensive analysis of the implementation background, conditions, specific measures and impact of Thailand's 30-baht medical plan, this paper compares Thailand's 30-baht medical plan with China's new rural cooperative system, and draws lessons from the successful experience of Thailand's 30-baht medical plan. In light of the specific conditions of China, this paper puts forward some suggestions for the further reform and improvement of the new rural cooperative system, and summarizes the problems and detours in the implementation of Thailand's 30-baht medical plan. This paper is divided into five parts: the first part, the introduction, the origin and significance of the topic, the literature review at home and abroad, the theoretical background, the definition of the concept and research methods; The second part mainly introduces the implementation background, conditions and measures of Thailand's 30-baht medical plan, including the situation of medical service institutions before the implementation of the 30-baht medical plan, the medical insurance situation, and the favorable conditions for its implementation. The initiatives of the Thai Government in the implementation of the 30-baht medical plan; the third part, the actual operation and impact of the 30-baht medical plan; and the 4th part, which compares Thailand's 30-baht medical plan with China's New Rural Cooperation from various aspects and draws on the experience, Summary of lessons. The author selected 20 interview subjects in Suratani city, Thailand, using the method of case interviews to collect qualitative data. The content of the interviews mainly includes the participants' understanding of the 30 baht medical plan and the degree of participation. Use degree and satisfaction degree and so on several aspects, and will collect the data to carry on the qualitative analysis, in order to understand the 30 baht medical plan concrete implementation situation, the implementation process policy change situation and the service object to this policy feedback; 5th part, Through the analysis of 30 baht medical plan, combined with the current concrete problems of China's New Rural Cooperation, the paper puts forward some countermeasures and suggestions to perfect the new rural cooperative system. The 30 baht medical plan of Thailand has important reference function to the new rural cooperative system of China. NCMS should start with reducing the cost, standardize the drug catalogue, reform the payment method to control the medical expenses, and on this basis, further increase the financial input and gradually raise the level of guarantee.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F843.36;F323.89;F842.684;R197.1

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