西藏农牧区医疗保障制度研究
发布时间：2019-05-10 04:34
【摘要】：西藏地处祖国西南边陲，自然环境、气候条件特殊，全区303.30万人,其中男性人口为155.29万人，女性人口是148.01万人口,农牧区的人口占全区人口比例的75.9%，大约是220万。较快的人口增长率和较慢的收入增长以及落后的基础设施建设是目前西藏自治区面临的主要问题。 西藏农牧区医疗系统是基于免费的医疗保障系统,改革开放30年来，随着西藏人民生活质量的提高和人口数量的逐年增加，西藏农牧区对医疗保健的需求也不断的提高、医疗卫生服务范围也随之不断扩大，但是政府免费的医疗资金已经远远不能满足基本医疗和预防保健的需求。1993年的时候颁布了《自治区免费医疗暂行管理办法》明确规定了西藏自治区地（市）、县三级财政为农牧民大众每人每年的无偿的医疗专项经费。1997年，根据中央政府关于卫生改革与发展的决定，西藏自治区提出了在免费医疗基础上建立和推行农牧区合作医疗制度，同年9月西藏自治区提出了建立和发展合作医疗试点的原则、措施等。12003年《西藏自治区免费医疗暂行管理办法》明确规定了农牧区医疗制度覆盖全区所有农牧民，进一步完善以免费医疗为基础的农牧区医疗保障制度。到2006年底的时候，全区农牧民合作医疗保障覆盖的面积达到了74个县（市），692个乡镇所有农牧民。加强全区农牧民医疗保障制度的建设，协调与全国各地区相一致的小康社会建设步调，切实实现农牧民的医疗保障水平和利益、全区农牧区卫生事业的全面健康发展。 基于西藏的历史，文化特征，，通过大量搜集文献，分析西藏农牧区合作医疗体系的现状并从五个部分进行论述： 第一章绪论，对文章研究的目的、意义及国内外对农村医疗体制研究进行阐述。西藏处于祖国的西南边陲，基础设施落后，卫生事业建设起步较晚，农牧区农牧民“看病难、看病贵、因病致贫、因病返贫”的现象十分严重，进一步建立和完善农牧区医疗保障制度，从而保障农牧民能顺利就医、提高农牧区的卫生条件、质量。 第二章对相关概念进行界定和对相关理论进行阐述。主要介绍医疗保障、城镇医疗保障、农村医疗保障及西藏农牧区医疗保障的相关概念和公共物品理论、人力资本理论、公平效率理论。 第三章对农牧区医疗保障制度的现状进行了分析；对医疗保障制度建设取得的成绩、藏医药的发展进行了回顾；对农牧区农牧民合作医疗的成效及存在的问题分析。 第四章对上海、山东、新疆等各省地区的农村合作医疗取得的成效进行了分析、比较，对西藏农牧区农牧民合作医疗的进一步完善获得可借鉴的经验。 第五章提出了完善西藏农牧区医疗保障制度的政策建议如：巩固完善农牧区医疗保障制度；进一步完善医疗卫生服务体系；提升农牧区医疗人才队伍素质建设；普及和提高农牧区医疗知识水平.继承和发展藏医药事业。
[Abstract]:Tibet is located in the southwest border of the motherland, with a natural environment and special climatic conditions. There are 3.033 million people in the region, of whom 1.5529 million are male and 1.4801 million are female. The population of agricultural and pastoral areas accounts for 75.9 percent of the total population of the region. It's about 2.2 million. Rapid population growth rate and slow income growth, as well as backward infrastructure construction, are the main problems facing the Tibet Autonomous region at present. The medical care system in the agricultural and pastoral areas of Tibet is based on the free medical security system. In the past 30 years of reform and opening up, with the improvement of the quality of life of the Tibetan people and the increase of the population year by year, the demand for medical care in the agricultural and pastoral areas of Tibet has also continuously improved. The scope of medical and health services continues to expand, However, the government's free medical funds are far from meeting the needs of basic medical care and preventive health care. In 1993, the interim measures for the Administration of Free Medical Care in the Autonomous region were promulgated, which clearly stipulated the prefectures (municipalities) of the Tibet Autonomous region. The finance at the county level is a special annual free medical fund for farmers and herdsmen. In 1997, in accordance with the decision of the central government on health reform and development, The Tibet Autonomous region put forward the establishment and implementation of a cooperative medical system in agricultural and pastoral areas on the basis of free medical treatment, and in September of the same year, the Tibet Autonomous region put forward the principle of establishing and developing a pilot cooperative medical system. (1) in 2003, the interim measures for the Administration of Free Medical treatment in Tibet Autonomous region clearly stipulated that the medical treatment system in agricultural and pastoral areas covered all farmers and herdsmen in the whole region, and further improved the medical security system in agricultural and pastoral areas based on free medical treatment. By the end of 2006, the area covered by cooperative medical security for farmers and herdsmen in the region had reached 74 counties (cities) and 692 villages and towns. We will strengthen the construction of the medical security system for farmers and herdsmen in the whole region, coordinate the pace of building a well-off society in line with all regions of the country, realistically realize the level and interests of the medical security of farmers and herdsmen, and develop the health cause of the whole region in an all-round and healthy manner. Based on the historical and cultural characteristics of Tibet, this paper analyzes the present situation of cooperative medical system in agricultural and pastoral areas of Tibet through a large number of literature collection and discusses it from five parts: the first chapter is the introduction, the purpose of which is studied in this paper. The significance and the research of rural medical system at home and abroad are expounded. Tibet is located in the southwest border of the motherland, the infrastructure is backward, the construction of health services starts relatively late, and the phenomenon of "difficult and expensive medical treatment for farmers and herdsmen in agricultural and pastoral areas, poverty caused by illness and return to poverty due to illness" is very serious. To further establish and improve the medical security system in agricultural and pastoral areas, so as to ensure that farmers and herdsmen can obtain medical treatment smoothly and improve the hygienic conditions and quality of agricultural and pastoral areas. The second chapter defines the related concepts and expounds the related theories. This paper mainly introduces the related concepts and theories of medical security, urban medical security, rural medical security and medical security in agricultural and pastoral areas of Tibet, such as the theory of public goods, the theory of human capital and the theory of fairness and efficiency. The third chapter analyzes the present situation of the medical security system in agricultural and pastoral areas, reviews the achievements made in the construction of the medical security system, the development of Tibetan medicine, and analyzes the effectiveness and existing problems of cooperative medical care for farmers and herdsmen in agricultural and pastoral areas. The fourth chapter analyzes and compares the achievements of rural cooperative medical care in Shanghai, Shandong, Xinjiang and other provinces, and obtains the experience that can be used for reference in the further improvement of cooperative medical care for farmers and herdsmen in Tibetan farming and pastoral areas. The fifth chapter puts forward some policy suggestions to improve the medical security system in agricultural and pastoral areas of Tibet, such as: consolidating and perfecting the medical security system in agricultural and pastoral areas; further perfecting the medical and health service system; improving the quality construction of medical personnel in agricultural and pastoral areas; Popularize and improve the level of medical knowledge in agricultural and pastoral areas. Inherit and develop the cause of Tibetan medicine.
【学位授予单位】：西藏大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F842.684;R197.1;F323.89
本文编号：2473346
[Abstract]:Tibet is located in the southwest border of the motherland, with a natural environment and special climatic conditions. There are 3.033 million people in the region, of whom 1.5529 million are male and 1.4801 million are female. The population of agricultural and pastoral areas accounts for 75.9 percent of the total population of the region. It's about 2.2 million. Rapid population growth rate and slow income growth, as well as backward infrastructure construction, are the main problems facing the Tibet Autonomous region at present. The medical care system in the agricultural and pastoral areas of Tibet is based on the free medical security system. In the past 30 years of reform and opening up, with the improvement of the quality of life of the Tibetan people and the increase of the population year by year, the demand for medical care in the agricultural and pastoral areas of Tibet has also continuously improved. The scope of medical and health services continues to expand, However, the government's free medical funds are far from meeting the needs of basic medical care and preventive health care. In 1993, the interim measures for the Administration of Free Medical Care in the Autonomous region were promulgated, which clearly stipulated the prefectures (municipalities) of the Tibet Autonomous region. The finance at the county level is a special annual free medical fund for farmers and herdsmen. In 1997, in accordance with the decision of the central government on health reform and development, The Tibet Autonomous region put forward the establishment and implementation of a cooperative medical system in agricultural and pastoral areas on the basis of free medical treatment, and in September of the same year, the Tibet Autonomous region put forward the principle of establishing and developing a pilot cooperative medical system. (1) in 2003, the interim measures for the Administration of Free Medical treatment in Tibet Autonomous region clearly stipulated that the medical treatment system in agricultural and pastoral areas covered all farmers and herdsmen in the whole region, and further improved the medical security system in agricultural and pastoral areas based on free medical treatment. By the end of 2006, the area covered by cooperative medical security for farmers and herdsmen in the region had reached 74 counties (cities) and 692 villages and towns. We will strengthen the construction of the medical security system for farmers and herdsmen in the whole region, coordinate the pace of building a well-off society in line with all regions of the country, realistically realize the level and interests of the medical security of farmers and herdsmen, and develop the health cause of the whole region in an all-round and healthy manner. Based on the historical and cultural characteristics of Tibet, this paper analyzes the present situation of cooperative medical system in agricultural and pastoral areas of Tibet through a large number of literature collection and discusses it from five parts: the first chapter is the introduction, the purpose of which is studied in this paper. The significance and the research of rural medical system at home and abroad are expounded. Tibet is located in the southwest border of the motherland, the infrastructure is backward, the construction of health services starts relatively late, and the phenomenon of "difficult and expensive medical treatment for farmers and herdsmen in agricultural and pastoral areas, poverty caused by illness and return to poverty due to illness" is very serious. To further establish and improve the medical security system in agricultural and pastoral areas, so as to ensure that farmers and herdsmen can obtain medical treatment smoothly and improve the hygienic conditions and quality of agricultural and pastoral areas. The second chapter defines the related concepts and expounds the related theories. This paper mainly introduces the related concepts and theories of medical security, urban medical security, rural medical security and medical security in agricultural and pastoral areas of Tibet, such as the theory of public goods, the theory of human capital and the theory of fairness and efficiency. The third chapter analyzes the present situation of the medical security system in agricultural and pastoral areas, reviews the achievements made in the construction of the medical security system, the development of Tibetan medicine, and analyzes the effectiveness and existing problems of cooperative medical care for farmers and herdsmen in agricultural and pastoral areas. The fourth chapter analyzes and compares the achievements of rural cooperative medical care in Shanghai, Shandong, Xinjiang and other provinces, and obtains the experience that can be used for reference in the further improvement of cooperative medical care for farmers and herdsmen in Tibetan farming and pastoral areas. The fifth chapter puts forward some policy suggestions to improve the medical security system in agricultural and pastoral areas of Tibet, such as: consolidating and perfecting the medical security system in agricultural and pastoral areas; further perfecting the medical and health service system; improving the quality construction of medical personnel in agricultural and pastoral areas; Popularize and improve the level of medical knowledge in agricultural and pastoral areas. Inherit and develop the cause of Tibetan medicine.
【学位授予单位】：西藏大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F842.684;R197.1;F323.89
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