摘要
目的:通过基线调查与两次追踪调查的比较,了解新型农村合作医疗制度(简称新农合)实施后,门诊与住院医疗费用的变化情况,评价新农合的实施对农民医疗费用的影响,为进一步完善新农合实施方案提供科学依据。方法:进行入户调查,采用多阶段分层整群随机抽样法抽取婺源县3个乡镇9个行政村,每村调查70户,将结果与前两年调查结果进行纵向对比研究。结果:农民年人均医疗费用由2003年的212.62元增至2005年的385.37元,平均增长速度达到34.63%;其中门诊费用为183.53元,住院费用为201.84元,均较前明显增加。住院费用变化主要是由20000元以上费用段费用增加所致,且次均住院费用以县以上医院增加为主,乡、县两级医院略有下降。2004年次均住院补偿费用813.59元,考虑物价上涨,抵消医疗费用增长,仅补偿251.58元,2005年的情况类似。结论:婺源县农民医疗费用上升较快,县以上医疗机构的医疗费用未得到有效控制,新农合给农民带来的补偿,大部分被医疗费用上涨所抵消。必须采用多种有效措施严格控制医疗费用增长。
Objective To understand the variation of farmers clinic and hospitalization cost change alter entorcing the new-type rural Cooperative Medical System （CMS） through comparing the base-line investigation with the two follow-up investigations. To appraise the impact of the new-type rural CMS implementation on medical cost and offer the scientific hasis for consummating the scheme of the new- type rural CMS further. Methods An investigation was carried out by asking residents in their homes. The multi-phase stratified cluster random sampling has been adopted to select 3 sample townships, 9 sample administrative villages and invest 70 families from each village. We have a lengthwise contrast research. Result The annual medical cost per capita raised from 212.62 Yuan in 2003 to 385. 37 Yuan in 2005. The average velocity of increase reaches to 34.63%. The annual outpatient clinic expenses per capita is 183.53 Yuan and the annual expenses per capita in hospital is 201.84 Yuan,which is higher than before. The expenses variance in hospital is resulted from expenses increase in a section of more than 20000 Yuan mainly. The average expense in hospital every time has been raised mainly in hospital of medical institutions above county,but that of countryside and county hospitals has been descended a little. The average compensation expense in hospital every time is 813. 59 Yuan in 2004. medical cost ,the average compensation expense in hospital Considered with price hike and offsetting the growth of every time is 251.58 Yuan. The status in 2005 is the same as that of 2004. Conclusion The medical cost of farmers in Wuyuan county has been increased quickly. That of medical institutions above county can＇t be controlled effectively. The compensation that the new-type rural CMS brought to farmers has been counteracted by the growth of medical cost. We should take many available measures to control it strictly.
出处
《中国农村卫生事业管理》
2006年第10期17-20,共4页
Chinese Rural Health Service Administration
