新型农村合作医疗住院受益公平性分析——以四川省富顺县为例

发布时间：2018-06-12 03:42

本文选题：新型农村合作医疗 + 公平性　；参考：《现代预防医学》2017年21期

【摘要】：目的利用集中指数和集中曲线分析四川省富顺县2015年新型农村合作医疗住院受益公平性,为进一步完善政策提供参考。方法采用多阶段分层随机抽样,抽取四川省富顺县3镇12村的农村居民进行结构式问卷访谈,采用家庭资产评估法对参加新农合的居民进行经济分组并计算住院率、应住院未住院率、住院补偿率和人均补偿比的集中指数并绘制集中曲线,以分析新农合对不同经济水平参保人群住院受益的公平性。结果住院服务利用方面,住院率、应住院未住院率的集中指数分别为-0.0974、-0.1717,二者的分布随着经济水平的降低均呈现增高趋势且应住院未住院的不公平程度较为严重;住院补偿方面,住院补偿率和人均补偿比的集中指数分别为-0.0017、-0.0634,住院是否获得补偿在人群中分布较为公平,而补偿费用占住院费用的比值在低收入人群中更高。结论新农合能有效保证低收入人群对住院医疗服务的利用,但应住院未住院的情况在低收入人群中更为突出;低收入人群获得补偿率和人均补偿比较高,但人群总体补偿比偏低。
[Abstract]:Objective to analyze the benefit fairness of the new rural cooperative medical system in Fushun County of Sichuan Province in 2015, and to provide reference for the further improvement of the policy in Fushun County of Sichuan province. Methods the multi stage stratified random sampling was used to select the rural residents in the 12 villages of Fushun County, Sichuan Province, and the rural residents were interviewed by the structured questionnaire, and the family assets assessment method was adopted. The residents who participated in the NCMS were divided into the economic group and the rate of hospitalization, the unhospitalization rate, the hospitalization rate and the concentration index of the per capita compensation ratio and the concentration curve were drawn to analyze the fairness of the inpatient benefits of the new CCMS at different economic levels. The distribution of the two index were -0.0974, -0.1717, and the distribution of the two were increased with the decrease of the economic level, and the unfairness of the inpatients was more serious; the hospitalization compensation, the concentration index of the hospitalization compensation rate and the per capita compensation ratio were -0.0017, -0.0634, and the distribution of the hospitalization compensation was fairly fair in the crowd. The ratio of the cost of compensation to the hospitalization costs is higher in the low income population. Conclusion the new CCMS can effectively ensure the use of hospitalized medical services for the low income population, but the situation that the inpatients should not be hospitalized is more prominent among the low-income people; the compensation rate of the low-income population and the per capita compensation is higher, but the total compensation ratio of the population is low.
【作者单位】：四川大学华西公共卫生学院(华西第四医院);
【基金】：国家自然科学基金项目(71303166) 美国中华医学基金会(CMB11-073)
【分类号】：F323.89;F842.684;R197.1

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