利益主体视角下的安徽省新农合发展问题研究

发布时间：2018-04-05 19:26

本文选题：新型农村合作医疗　切入点：异地结算　出处：《安徽大学》2015年硕士论文

【摘要】：新型农村合作医疗制度可以说是我国农村改革事业当中的一个重要的举措,农村卫生事业往前迈进了一大步,这初步缓解了广大农民因为生病而不敢去看病或者是一病回到解放前的窘境。我国是农业大国,农民占据了我国人口的绝大多数,保障农民的根本利益才能真正促进社会的健康持续发展。新型农村合作医疗保障制度对促进我国农村的社会保障体系的健全发展起到了关键性的作用。在近年的政协会议和其他重大会议上,都把新农合的问题放在了靠前的位置,突出了新农合的重要性,也体现了农民的主人翁地位。本文主要是分析安徽省新农合现实存在的一系列问题,来探讨解决问题的可行性方案,以期对全国新农合的完善提供一定的借鉴,为促进我国新农合制度的可持续健康发展出一份力。本文主要是分为六个章节的内容。第一章是绪论,包括五个小节的内容。第一小节是研究目的和研究意义；第二小节是国内外研究现状述评,包括国内学者和国外学者对我国新农合的研究；第三小节是本文研究的主要内容：第四小节是本文的研究方法和研究思路；第五小节是创新点和不足。第二章是相关理论基础与新农合制度的发展概述,包括两个小节的内容。第一小节是新农合的含义和特点;第二小节是相关理论基础；第三小节是新农合的发展历程。第三章是新农合制度利益主体分析,包括两个小节的内容。第一小节阐述利益主体分别是政府、农民、农村定点医疗机构；第二小节是利益主体间利益的对立博弈分析。第四章是安徽省新农合发展现状。包括安徽省新农合发展取得的成绩以及存在的问题。取得的成绩主要表现为：由单一“住院补偿报销”到“既可住院补偿又可门诊统筹”;报销比例得到提升,参合农民经济负担减轻；建立新农合信息系统,迈出了网上结算的一步。问题主要包括四大方面的问题。第一是新农合即时结算机制不完善。从政府、农民和农村定点医疗机构三方利益主体角度去分析主要表现为补偿标准不统一；提交材料过多；农村定点医疗机构需先垫付报销资金,负担重等。第二是城乡医疗保障制度分割。从三方利益主体的角度主要表现为两个制度中间的部门利益之争；统筹层次不一等。第三是疾病预防工作缺失。从三方利益主体的角度去分析表现为卫生保健工作不到位；农村定点医疗机构对农民健康的忽视；农民自身疾病预防意识差。第四是新农合基金监管不到位。从三方利益主体的角度表现为省级政府监管缺位：同级部门监管不力：对医生患者的监管不力；农民自身的维权意识不强等。针对以上存在的一系列问题,再从政府、农民、农村定点医疗机构的角度提出了解决方案。第五章是国外农村医疗保障模式以及启示。主要阐述了马来西亚、美国、泰国和韩国的农村医疗保障模式以及对我国新农合发展的启示。第六章是解决安徽省新农合问题的对策方案。比如完善新农合异地就医即时结算机制、统筹城乡医疗并轨、加强疾病预防工作、重视新农合基金监管。
[Abstract]:The new rural cooperative medical system can be said to be an important measure in our country ' s rural reform . The rural health cause has taken a big step forward , which has helped to alleviate the problem of farmers because they are sick and not to return to liberation . In recent years , the new rural cooperative medical security system has played a key role in promoting the healthy development of our country ' s rural social security system .
The second section is a review of the current research situation at home and abroad , including domestic scholars and foreign scholars ' research on China ' s new agriculture ;
The third section is the main content of this paper : the fourth section is the research method and the research thinking of this paper .
The fifth section is the innovation point and the deficiency . The second chapter is the summary of the development of the theory foundation and the new farming system , including the contents of the two sections . The first section is the meaning and characteristic of the new agricultural association ; the second section is the relevant theoretical basis ;
The third section is the development course of the new agriculture association . The third chapter is the analysis of the interests subject of the new agriculture association system , including the contents of the two sections . The first section explains that the main body of interest is the government , the farmer and the rural fixed - point medical institution .
The second section is the analysis of the opposite game between the interests of the benefit entities . The fourth chapter is the current situation of the development of the new agriculture in Anhui Province . The results are as follows : the single " hospitalization compensation reimbursement " to " both hospitalization compensation and outpatient co - ordination " ; the reimbursement proportion is promoted , and the economic burden of the participating farmers is reduced ;
The establishment of a new agricultural information system is a step towards the online settlement . The first is the problem of the four aspects . The first is that the mechanism of the instant settlement is not perfect . The analysis of the main performance of the tripartite interests of the government , the farmers and the rural fixed - point medical institutions is not unified ;
Too many submissions ;
The second is the division of medical security system between urban and rural areas .
The third is the absence of disease prevention .
The neglect of the health of farmers in rural fixed - point medical institutions ;
The fourth is that the supervision of the provincial government is not in place .
In this paper , the author puts forward a solution to the problems existing in rural areas , such as the rural medical security model in Malaysia , the United States , Thailand and South Korea , and the inspiration to the development of the new agriculture in China .

【学位授予单位】：安徽大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：F842.684;F323.89;R197.1

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