湛江市新型农村合作医疗发展研究

发布时间：2018-10-18 06:23

【摘要】：在建设社会主义和谐社会的进程中，农村与城市的和谐成为建设的重要内容之一，而农村医疗保障制度的建设又是重中之重。但是我国由于长期存在着城乡二元经济结构，城镇与农村之间实行的是不同的二元医疗保障结构，使得城市享受到了更多的政策优惠和资源配置，这对农村地区的医疗卫生事业发展造成了严重滞后的影响，农村地区存在着非常普遍的“看病难、看病贵”、“因病致贫、因病返贫”的现象。因此，，必须将农村医疗保障制度作为当前新农村建设的一项重要的基础性工程来建设。本文以新型农村合作医疗为研究对象，通过对其建设历程、运行现状、实施途径以及取得的成效做系统的分析，提出现行新型农村合作医疗制度在实施过程中仍然存在医药卫生体制改革困难重重、城乡区域卫生发展不平衡、药品加成政策短期内难以取消、基本药物制度的实施面临严峻考验和社保拖欠定点医疗机构的费用大幅增加的问题。这些问题阻碍了湛江市深入实施新型农村合作医疗保险的进程。本文并以湛江市东海岛三明村为个案，笔者前后用了两个多月的时间，随机选取三明村的农户，进行问卷调查。虽然有效问卷只有117份，但是调查是以“户”为单位，基本了解到每户农民新型农村合作医疗的情况，涉及总人数为500多人。通过对此样本的分析，基本掌握了三明村新型农村合作医疗的实施状况，也在一定程度上对湛江市新型农村合作医疗工作有更进一步的了解与说明。从问卷调查中，也反映出了一些问题，通过研究分析，并借鉴国外农村医疗保险制度的经验，就如何进一步改进新农村合作医疗制度进行了讨论：通过健全乡镇医疗卫生服务体系、建立国家基本药物制度、促进农村基本公共卫生服务逐步均等化、抓好公立医院改革试点以及推进卫生重点项目建设等具体措施来完善湛江市新型农村合作医疗制度，使农民的身体健康得到保障，享受到与城镇居民无差别的公平医疗卫生待遇。
[Abstract]:In the process of building a harmonious socialist society, the harmony between the countryside and the city becomes one of the important contents of the construction, and the construction of the rural medical security system is the most important. However, due to the existence of a dual economic structure between urban and rural areas for a long time, the dual medical security structure between urban and rural areas is different, which makes cities enjoy more preferential policies and resource allocation. This has caused serious lag in the development of medical and health services in rural areas. In rural areas, there is a very common phenomenon of "difficult to see a doctor, expensive to see a doctor", "to be poor because of illness, and to return to poverty because of illness". Therefore, the rural medical security system must be built as an important basic project in the construction of the new countryside. This article takes the new rural cooperative medical system as the research object, through the systematic analysis to its construction course, the running present situation, the implementation way and the achievement. It is pointed out that there are still many difficulties in the reform of the medical and health system during the implementation of the current new rural cooperative medical system, the development of health in urban and rural areas is not balanced, and it is difficult to cancel the policy of drug addition in the short term. The implementation of the essential drugs system is facing severe challenges and the cost of social security defaulting on designated medical institutions has increased substantially. These problems hindered Zhanjiang City from implementing the new rural cooperative medical insurance. This paper takes Sanming Village of East Island of Zhanjiang City as a case. The author used more than two months to select the farmers of Sanming Village at random and carry on the questionnaire survey. Although there are only 117 valid questionnaires, the survey is based on the "households", and basically understands the situation of the new rural cooperative medical system for each farmer, involving a total of more than 500 people. Through the analysis of this sample, the author basically grasps the implementation situation of the new rural cooperative medical system in Sanming village, and to a certain extent has a further understanding and explanation of the new rural cooperative medical treatment in Zhanjiang city. From the questionnaire survey, also reflects some problems, through research and analysis, and learn from the experience of foreign rural medical insurance system, This paper discusses how to further improve the new rural cooperative medical service system: by perfecting the township medical and health service system, establishing the national essential medicine system, and promoting the gradual equalization of rural basic public health services, To improve the new rural cooperative medical care system in Zhanjiang, and to ensure the health of farmers, we should do a good job of carrying out the pilot reform of public hospitals and promoting the construction of key health projects. Enjoy fair medical and health treatment without distinction with urban residents.
【学位授予单位】：广东海洋大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F323.89;F842.684;R197.1

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