摘要
目的:评价新型农村合作医疗实施"按人头支付"改革对参合农民门诊医疗费用控制的效果。方法:收集浦东新区"按人头支付"改革实施前、后的新型农村合作医疗运行数据以及35万参合农民2011—2012年1 160万门诊人次的就诊费用、补偿金额等数据并进行比较分析。结果:新型农村合作医疗支付方式改革后,对于控制门诊医疗费用的过快增长有明显作用,进而有利于确保新型农村合作医疗基金收支平衡。结论:目前,按人头支付改革仅使得社区卫生服务机构初步形成自我约束机制,如何激励二、三级医院医务人员主动控费,制定配套政策有待深入研究。
Objective： To evaluate the effect of controlling the outpatient medical expenses for participating farmers after the implementation of capitation reform under new rural cooperative medical system（NCMS）. Methods： It collected the NCMS operational data before and after the implementation of capitation reform. The data included 11.6 million outpatient records about treatment cost, the amount of compensation and other data from 2011 to 2012. Results： After the capitation reform, the excessive growth of medical costs obtained a certain degree control, and the NCMS fund was more secure. Conclusion： Capitation reform only made an initial mechanism of self-restraint for community health service centers. Further studies are needed on how to motivate the staff in secondary and tertiary hospitals to control medical expense actively.
出处
《中国卫生经济》
北大核心
2014年第2期21-24,共4页
Chinese Health Economics
基金
上海市卫生局局级科研项目(20124391)
上海市浦东新区卫生系统优秀青年医学人才培养(PWRq2013-21)
上海市浦东新区卫生局卫生科技项目(PW2012A-55
PW2012A-57)
国家自然科学基金青年项目(71003024)
