海南省新型农村合作医疗参合农民乡镇住院“限费医疗”效果评价

发布时间：2018-06-01 10:04

本文选题：新型农村合作医疗 + 限费医疗　；参考：《中国卫生经济》2017年08期

【摘要】：目的:评价新型农村合作医疗新农合参合农民乡镇住院"限费医疗"政策对住院利用、就诊流向、患者经济负担及农合资金分配的影响,为完善相关政策提供依据。方法:数据主要来源于新农合报表、医院统计报表和住院病历等资料,评价指标主要选取住院人次、次均住院费用以及次均自付费用、农合资金分配比等。分析方法主要采用描述性分析和倍差法模型,并结合访谈资料对定量研究结果进行补充和解释。结果:该政策可能增加乡镇卫生院的住院人次数,对促进患者留在乡镇卫生院的作用有限;乡镇卫生院全病种次均住院费用和自付费用均下降;实施了限费医疗政策的万宁市高血压、肺炎的次均住院费用均无明显变化,而次均自付费用分别上升了11%和28%;对新型农村合作医疗资金分配无显著影响。结论:该政策对控制医疗总费用有积极作用,但对患者合理分流和农合资金分配作用有限。对病人住院经济负担的影响因病种而异,小病可能会增加自付费用。
[Abstract]:Objective: to evaluate the effects of the new rural cooperative medical system (NCMS) policy on the utilization of hospitalization, the direction of visits, the economic burden of patients and the allocation of rural cooperative funds, so as to provide the basis for the improvement of the relevant policies. Methods: the data were mainly from the NCMS report, the hospital statistical report and the medical record of the hospital. The evaluation indexes were mainly selected as the person-time of hospitalization, the average cost of hospitalization and the expense of paying for the second time, the ratio of the distribution of rural cooperative funds and so on. The analytical method mainly adopts descriptive analysis and double difference model, and combines with interview data to supplement and explain the quantitative research results. Results: the policy may increase the number of hospital visits in township health centers, and has limited effect on promoting patients to stay in township hospitals, and the average hospitalization expenses and out-of-pocket expenses of all diseases in township hospitals are decreased. The average hospitalization cost of pneumonia in Wanning City, which implemented the policy of limiting medical treatment, did not change significantly, while the average out-of-pocket cost increased by 11% and 28% respectively, which had no significant effect on the distribution of funds of the new rural cooperative medical system. Conclusion: the policy has a positive effect on controlling the total medical cost, but it has limited effect on reasonable shunt of patients and allocation of rural cooperative funds. The impact on the financial burden of hospitalization varies from disease to disease, and minor illnesses may increase out-of-pocket costs.
【作者单位】：北京大学公共卫生学院;海南省卫生和计划生育委员会;
【基金】：国家自然科学基金项目(71273016、71673004)
【分类号】：F323.89;F842.684;R197.1

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