枣庄市城乡居民基本医疗保险运行效果评价研究

发布时间：2019-01-20 19:02

【摘要】：近年来,国家极其重视整改医疗保障制度,加大公共投入,加快推进新型农村合作医疗(以下简称“新农合”)和城镇居民医疗保险(以下简称“城居保”)的建设,迅速扩大医保覆盖面范围,缓解城乡居民就医困难,费用高昂的问题。但是城乡二元结构的存在,致使我国城乡医保制度分立现象日益明显,从而致使其失衡。伴随经济社会的不断发展,多种医疗保险并行的制度不能满足参保人员的需求。因此,党中央明确提出全面筹划城乡社会保障体系建设。同时,新医改方案确立了“覆盖全民、全民医保”的重要目标和任务。然而,仍有部分专家表示,结合目前实际国情可知,实现城乡医保一体化是一个长期循序渐进的过程,操之过急反而会适得其反。各地区在经济状况、人均收入、就医观念、制度干预等诸多方面存在的差异导致城乡居民基本医疗保险(以下简称“城乡居民医保”)在各地推行的模式、实施方案也不同。因此,至今仍未有一个完整的评价指标体系。但是,科学合理评价枣庄市城乡居民医保的运行状况,提高运行质量,促进该制度健康持续发展的前提,必须是构建一套关于该制度运行效果的评价指标体系。本篇论文采用理论与实证分析相结合的方法,第一,简述了城乡居民医保的相关概念和理论,分析了枣庄市2010年-2014年新农合的基本情况;第二,对枣庄市城乡居民医保的运行现状进行总体评价。在此基础上,运用变异系数法和聚类分析法以及专家咨询法,设计出一套城乡居民医保运行效果评价指标体系。然后,运用主成分分析法,对枣庄市5区1市城乡居民医保的运行效果进行综合评价,根据2个主成分综合得分发现,滕州市与市中区的运行效果较好,滕州市得分最高,市中区的综合得分为正值,峄城区、山亭区、台儿庄区、薛城区的综合得分依次递减,且均为负值,综合得分与运行效果成正比,因此这四个区的运行效果在全市排名相对落后。最后,根据评价结果对进一步完善该制度给出建议。
[Abstract]:In recent years, the state has attached great importance to rectifying and reforming the medical security system, increasing public investment, and speeding up the construction of the new rural cooperative medical care system (hereinafter referred to as "new rural cooperative medical system") and the medical insurance for urban residents (hereinafter referred to as "urban housing insurance"). Rapidly expand the coverage of health insurance, ease the difficulties of urban and rural residents access to health care, expensive problems. However, the existence of urban-rural dual structure makes the phenomenon of urban and rural medical insurance system more and more obvious, which leads to its imbalance. With the development of economy and society, the concurrent medical insurance system can not meet the needs of the insured. Therefore, the Party Central Committee clearly put forward a comprehensive plan for urban and rural social security system construction. At the same time, the new medical reform program has established the important goal and task of "covering the whole people, universal health insurance". However, some experts still say, combined with the actual situation, the realization of urban and rural health care integration is a long-term gradual process, too soon will be counterproductive. The differences in economic status, per capita income, medical concept and system intervention in different regions lead to different modes and implementation schemes of basic medical insurance for urban and rural residents (hereinafter referred to as "medical insurance for urban and rural residents"). So far, there is not a complete evaluation index system. However, a scientific and reasonable evaluation of the operation of urban and rural residents in Zaozhuang City, improving the quality of operation, and promoting the healthy and sustainable development of the system must be a set of evaluation index system about the operating effect of the system. This paper adopts the method of combining theory with empirical analysis. Firstly, it briefly introduces the related concepts and theories of urban and rural residents' medical insurance, and analyzes the basic situation of the new rural cooperation in Zaozhuang City from 2010 to 2014. Second, the operation of urban and rural residents in Zaozhuang City health insurance status of the overall evaluation. On this basis, using variation coefficient method, cluster analysis method and expert consultation method, a set of evaluation index system of urban and rural residents' health insurance operation effect is designed. Then, by using principal component analysis method, the operation effect of medical insurance for urban and rural residents in 5 districts and 1 city of Zaozhuang City is comprehensively evaluated. According to the comprehensive scores of the two principal components, it is found that the operation effect of Tengzhou City and Shizhong District is better, the score of Tengzhou City is the highest. The comprehensive scores of Shizhong District are positive, Yicheng District, Shanting District, Taierzhuang District and Xue Cheng District are decreasing in turn, and all of them are negative. The comprehensive score is in direct proportion to the effect of operation. As a result, the operation of the four districts in the city ranked relatively backward. Finally, according to the evaluation results, some suggestions are given to further improve the system.
【学位授予单位】：安徽农业大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：F842.684

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