潍坊市新型农村合作医疗发展问题研究

发布时间：2018-03-24 22:16

本文选题：新型农村合作医疗　切入点：筹资主体　出处：《山东农业大学》2014年硕士论文

【摘要】：自2002年10月,我国明确提出各级政府要积极引导农民建立以大病统筹为主的新型农村合作医疗制度后,新型农村合作医疗在全国各地迅速发展起来,参合率、筹资总额、补偿比例不断提高,合作医疗是由我国农民自己创造的互助共济的医疗保障制度,它在保障农民获得基本卫生服务、缓解农民因病致贫和因病返贫方面发挥了重要的作用,为世界各国,特别是发展中国家所普遍存在的问题提供了一个范本,受到了农民群众的普遍欢迎。潍坊市新型农村合作医疗制度从2001年开始探索,在发展过程中经历了自行探索、初步发展、全面推开等三个阶段,到目前为止取得了显著成绩,农民获益颇多。尽管潍坊市新型农村合作医疗取得了一些成绩,但在发展过程中,特别是在目前城乡医保并轨的过渡期,依然存在许多问题,这些问题的存在阻碍了潍坊市新型农村合作医疗效用的发挥,需要采取措施尽快切实加以解决。本文立足于潍坊市,借鉴已有的研究成果,通过调查研究,结合本人实际工作的经历,采用比较分析、实证举例、定量分析、系统归纳等方法,阐述了四种医疗保险制度模式,指出我国的医疗保险制度模式从总体特征来看属于社会医疗保险性质,说明了我国合作医疗的发展历程,指出新型农村合作医疗制度是在传统农村合作医疗基础上发展起来的,同时介绍了新型农村合作医疗的理论基础,为本文的研究提供了理论依据。论文介绍了潍坊市新型农村合作医疗的主要做法、取得的成绩,指出潍坊市新农合在参合率、筹资额度、补偿率上都有了大幅提升,基金运行规范有效,大病保障框架基本建立,医疗救助制度发挥实效,三级医疗卫生服务网络建设飞速发展,并结合实践说明了潍坊市新农合运行中存在的问题,包括出资主体不健全,筹资水平仍较低;定点医疗机构偏少,分布不均;职能不顺,监督机制不健全;乡村卫生基础设施依然落后等;最后阐释了潍坊市新型农村合作医疗的发展策略,指出潍坊市新型农村合作医疗的发展要遵循一定的原则,采取多种策略,需要在继续深化医药卫生体制改革的基础上,进一步健全筹资主体,延伸统筹层次,改革补偿模式,提高补偿水平,加大医疗救助力度、进一步健全全市基层医疗卫生服务网络,按照《山东省整合城乡居民基本医疗保险工作实施方案》的要求,逐步向城乡医保并轨过渡。
[Abstract]:Since October 2002, the government at all levels of our country has clearly proposed that the farmers should be actively guided to establish a new rural cooperative medical care system, which is mainly concerned with serious illness. After that, the new rural cooperative medical system has developed rapidly throughout the country, with participation rate and total amount of funds raised. The proportion of compensation continues to increase. Cooperative medical care is a medical security system created by farmers in our country. It plays an important role in guaranteeing farmers access to basic health services and alleviating poverty caused by illness and returning to poverty because of illness. It provides a model for the problems that exist all over the world, especially in the developing countries, and is generally welcomed by the peasants. Weifang's new rural cooperative medical system has been explored since 2001. In the process of development, we have experienced three stages: self-exploration, preliminary development and all-around development. So far, remarkable achievements have been made, and farmers have benefited a lot. Although Weifang New Rural Cooperative Medical Scheme has made some achievements, However, in the process of development, especially in the transition period of urban and rural medical insurance integration, there are still many problems, which hinder the effectiveness of the new rural cooperative medical system in Weifang. We need to take measures to solve the problem as soon as possible. This paper bases on Weifang city, draws lessons from the existing research results, through investigation and research, combining with my actual work experience, using comparative analysis, empirical examples, quantitative analysis, This paper expounds four kinds of medical insurance system models, points out that the medical insurance system mode in our country belongs to the nature of social medical insurance from the general characteristics, and explains the development course of cooperative medical system in China. It is pointed out that the new rural cooperative medical system is developed on the basis of the traditional rural cooperative medical system, and the theoretical basis of the new rural cooperative medical system is also introduced. The paper introduces the main methods of the new rural cooperative medical system in Weifang, and points out that the new rural cooperative medical system in Weifang has greatly promoted the participation rate, the financing quota and the compensation rate. The operation of the fund is standardized and effective, the guarantee framework for serious illness is basically established, the medical aid system is effective, the three-level medical and health service network is developing rapidly, and the problems existing in the operation of Weifang New Rural Cooperation are explained in combination with practice. The main body of investment is not perfect, the level of financing is still low; the number of designated medical institutions is on the low side, the distribution is uneven, the function is not good, the supervision mechanism is not perfect, the rural health infrastructure is still backward, etc. Finally, the paper explains the development strategy of the new rural cooperative medical system in Weifang, and points out that the development of the new rural cooperative medical system in Weifang should follow certain principles, adopt various strategies, and continue to deepen the reform of the medical and health system. We will further improve the main body of fund-raising, extend the overall planning level, reform the compensation model, raise the level of compensation, increase the intensity of medical assistance, and further improve the basic level medical and health service network of the city. In accordance with the requirements of the implementation Plan of integrating the basic Medical Insurance for Urban and Rural residents in Shandong Province, the transition to the integration of urban and rural medical insurance should be gradually carried out.
【学位授予单位】：山东农业大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R197.1;F842.684;F323.89

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