摘要
目的分析甘肃省新型农村合作医疗门诊统筹2010—2015年间的运行效果,指出政策执行过程中存在的问题并给予解决措施。方法从甘肃省新型农村合作医疗管理中心及华东公司提取2010—2015年新型农村合作医疗门诊运行相关数据以及年度报表,分析方法采用描述性统计分析和卡方检验。结果实行门诊统筹后,新型农村合作医疗参合率由95.92%提高到98.31%(χ~2=337 789.30,P=0.000),但门诊统筹支出所占比例由18.15%降为14.18%;门诊就诊率由101.83%提高到205.38%,患者更多的流向村级卫生室(χ~2=4 105 747.66,P=0.000);次均门诊费用由29.81元提高到37.88元,次均补偿费用由18.67元提高到29.07元,门诊补偿比由62.63%提高到76.75%,但2014年次均补偿费用和门诊补偿比均呈下降趋势。结论门诊统筹提高了新型农村合作医疗的参合率,补偿比例逐年提高,有效释放了患者就医需求,促进了患者向村卫生室流动,同时也存在门诊统筹基金减少、补偿公平性和保障能力有待提高的问题。
OBJECTIVE To analyze the operation effect for outpatient seivice of New Rural Cooperative Medical System（NCMS） in 2010 to 2015 and point out the problems existing in the policy implementation process and give solutions. METHODS Collecting data and annual reports about the NCMS operating status from NCMS management office and Huadong company in 2010 to 2015, using methods of descriptive analysis and Chi-square Test. RESULTS After the implementation of outpatient service raising participation rate from 95.92% to 98.31%, but the proportion of outpatient spending reduced from 18.15% to 14.18%. Outpatient rate from 101.83% to 205.38% and the more patients flow to village clinics（Overall X2=4105747.66, P=0.000）. Time outpatient expenses in- creased from 29.81 yuan to 37.88 yuan, the time compensation fees increased from 18.67 yuan to 29.07 yuan, the outpatient service compensation ratio increased from 62.63% to 76.75%, but the rate of their compensation fees and outpatient compensation tend to re- duce in 2014. CONCLUSION The implementation of outpatient service raising participation and release the farmers＇medieal needs ef- fectively. Promoting more outpatients flowing to the village clinics and proportion of compensation raised by year, but also existed in outpatient funds reduced and compensation level, compensation fairness remained to be further improved.
作者
张倩倩
王震
陈永聪
郑亚君
ZHANG Qian-qian WANG Zhen CHEN Yong-cong et al(School of Public Health, Lanzhou University, Lanzhou 730000, Chin)
出处
《中国初级卫生保健》
2017年第10期16-18,共3页
Chinese Primary Health Care
