新型农村合作医疗效果评价指标体系建立及应用研究

发布时间：2018-06-18 14:31

本文选题：新型农村合作医疗保险 + 评价　；参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：本研究通过建立一套综合、全面、可操作的新型农村合作医疗保险的评价指标体系,并用这个指标体系对新疆县(市)新型农村合作医疗的运行效果进行评价分析。方法：运用Epidata3.0进行数据录入,建立基础数据库,Spss13.0对收集的数据整理分析,利用德尔菲法建立新型农村合作医疗评价指标体系,用变异系数法计算各个指标权重,通过层次分析法计算各个县(市)的综合得分,判断各县(市)新农合运行效果。结果：(1)指标体系建立：新农合评价指标体系包括四个一级指标、十二个二级指标和三十二个三级指标,一级指标为公平、效率、质量和可持续性,二级指标为社会公平、配置效率、满意度、社会支持度等等,三级指标包括参合率,贫困人口参合率等等。(2)新农合效果评价结果：从调查数据研究可以看到,综合得分排在第一的乌恰县,由一级指标可以看出公平性的贡献最大,注重公平,综合得分排在最后的是泽普县。效率最好的是额敏县,质量最好的是阿勒泰市,可持续性最好的是叶城县,53个县的平均得分是0.667。结论：管理与监督是建立有效新型农村合作医疗制度的重要环节,效果评价是新农合评价中最重要的部分,因此,建立合理、科学的评价体系是至关重要的。各个县(市)新农合运行稳定,公平性差异较小,仍有待进一步提高；整体效率偏低,主要体现在住院费用高居不下；质量处于平稳阶段,提高患者满意度是衡量质量的重要内容；可持续性不容乐观,表现在保险基金持续透支难以保证新农合的有效运行；增加财政投入,改变筹资模式,加大政策支持,针对各个县(市)的实际情况,因地制宜的提出实施方案,保证新农合制度有效运行。
[Abstract]:Objective: to establish a comprehensive, comprehensive and operable evaluation index system of the new rural cooperative medical insurance, and to evaluate and analyze the operation effect of the new rural cooperative medical system in the counties (cities) of Xinjiang. Methods: Epidata 3.0 was used to input the data, the basic database was set up to collect and analyze the data collected and the Delphi method was used to establish the evaluation index system of the new rural cooperative medical system. The weight of each index was calculated by the variation coefficient method. The comprehensive score of each county (city) is calculated by analytic hierarchy process (AHP) to judge the operation effect of NCMS in each county (city). Results the index system was established: the evaluation index system of NCMS includes four primary indexes, twelve second-class indicators and thirty-two third-level indicators. The first class index is equity, efficiency, quality and sustainability, and the second grade index is social equity. Allocation efficiency, satisfaction, social support, and so on. The third level indicators include participation rate, poverty participation rate, etc.) the evaluation results of the new rural cooperation effect: from the research of survey data, we can see that Wucha County, which has the first comprehensive score, is ranked first. We can see that the contribution of fairness is the most important, and the comprehensive score ranks last in Zepu County. Eimin County is the most efficient, Altay is the best quality, Yecheng County is the best sustainability, the average score of 53 counties is 0. 667. Conclusion: management and supervision is an important link in the establishment of an effective new rural cooperative medical system, and the effect evaluation is the most important part in the evaluation of the new rural cooperative medical system. Therefore, it is very important to establish a reasonable and scientific evaluation system. The operation of NCMS in various counties (cities) is stable and the equity difference is small, which still needs to be further improved; the overall efficiency is on the low side, mainly reflected in the high hospitalization expenses; the quality is at a stable stage. Improving patient satisfaction is an important part of quality measurement; sustainability is not optimistic, as the insurance fund overdraft is difficult to ensure the effective operation of NCMS; increase financial investment, change the funding model, increase policy support, According to the actual situation of each county (city), the implementation plan is put forward according to the local conditions to ensure the effective operation of the new agricultural cooperation system.
【学位授予单位】：新疆医科大学
【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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