甘肃省新型农村合作医疗基金运行绩效评价研究

发布时间：2018-06-05 03:48

本文选题：新农合基金 + 绩效评价　；参考：《兰州大学》2017年硕士论文

【摘要】：新型农村合作医疗(以下简称新农合)制度不仅是凸显我国医疗现状的重要载体,也是构建多元化农村医疗保障体系的重要组成部分,其不断发展和完善对提高农民的健康水平、缓解农民“看病难、看病贵”等问题具有重要意义。而新型农村合作医疗基金作为新农合制度可持续发展的关键,其运行好坏不仅是衡量基金管理制度是否完善的重要标准,也关乎着参合农民的切身利益。本文首先在梳理新农合基金运行绩效相关文献的基础上,以公共财政支出理论、政府绩效管理理论、利益相关者理论为理论依据,并在逻辑模型和政府绩效评价“4E”准则的框架下,以及德尔菲法的指标筛选后,构建了一套包括经济发展水平、筹资水平、管理水平和参合受益水平4个一级指标和农民人均纯收入、人均筹资额等12个二级指标的新农合基金运行绩效评价指标体系。其次,运用因子分析法对甘肃省2014年14个市州新农合基金运行情况进行分析,并提取了“基金利用”、“基金筹资”和“参合受益”三个公因子。根据数据分析结果,发现甘肃省新农合基金整体上运行较好,但各市(州)之间基金运行不平衡,相互之间还存在差异;新农合基金的良性运行和当地经济发展水平、农民的支出能力和意愿、政府财政补助、基金的监管程度等因素密切相关。最后,在相关数据分析和甘肃省新农合基金运行现存问题的基础上,本文从立足地区经济发展特色,促进医疗卫生资源合理配置;稳步提升财政补助标准,优化基金筹资结构;加强新农合基金监管和合理使用;提高实际补偿比和参合受益水平等方面尝试性地提出对策建议。
[Abstract]:The new rural cooperative medical system (hereinafter referred to as NCMS) is not only an important carrier to highlight the current medical situation of our country, but also an important part of constructing a diversified rural medical security system. Its continuous development and perfection is of great significance to improve the health level of farmers and alleviate the problems of "difficult and expensive to see a doctor". As the key to the sustainable development of the new rural cooperative medical system, the operation of the new rural cooperative medical fund is not only an important standard to measure whether the fund management system is perfect, but also related to the vital interests of participating farmers. On the basis of combing the literature about the performance of the new rural cooperative fund, this paper takes the public finance expenditure theory, the government performance management theory, the stakeholder theory as the theoretical basis. Under the framework of the logical model and the "4e" criterion of government performance evaluation, and after the selection of indicators by Delphi method, a set of economic development level and financing level are constructed. The evaluation index system of the performance of the NRCF is composed of four first-level indexes and 12 second-level indexes, such as the management level and the benefit level of participation and cooperation, and the per capita net income of farmers and the amount of capital raised per capita. Secondly, the paper analyzes the operation of NCMS in 14 cities and states of Gansu province in 2014 by using factor analysis method, and extracts three common factors of "fund utilization", "fund financing" and "benefit from participation and cooperation". According to the results of data analysis, it is found that the new rural cooperative fund in Gansu Province is running well as a whole, but the operation of the fund is unbalanced among the cities (states), and there are still differences between them, and the benign operation of the new rural cooperative fund and the level of local economic development are still different. The expenditure ability and willingness of farmers, government financial subsidy, fund supervision and other factors are closely related. Finally, based on the analysis of relevant data and the existing problems in the operation of the new rural cooperative fund in Gansu province, this paper promotes the rational allocation of medical and health resources on the basis of the characteristics of regional economic development, steadily raises the financial subsidy standard, and optimizes the fund financing structure. To strengthen the supervision and rational use of the new rural cooperative fund, to raise the actual compensation ratio and the level of benefit from the participation and cooperation, and so on, to put forward some countermeasures and suggestions.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1;F842.684;F323.89

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