摘要
目的:分析会宁县县外住院病人资料,探讨新农合支付方式改革和分级诊疗政策对住院病人县外就医行为和费用变化情况影响。方法:采用定性定量研究结合的方法,收集甘肃省和会宁县新农合报表资料进行描述性统计分析;收集支付方式改革和分级诊疗制度相关文件进行政策文件分析;对关键知情者进行访谈。结果:支付方式改革后县外就医比例增幅减小,逐渐转为下降趋势,个人支付比例降低;分级诊疗后县外就医人数比例与新农合资金支出比例下降,个人支付比例增高。结论:支付方式改革和分级诊疗对控制县外住院就医有积极作用;分级诊疗有效减少了县外住院就医和新农合资金支出比例,但个人自付费用有一定幅度上升。
Objective To analyze the reimbursement annual data of out--of--county inpatients to explore the effects of payment reform of NCMS and policies for grading treatment on hospitalization and expenditure change in Huining County. Methods Mixed research method was employed in this study. Quantitative research method was used in NCMS annual report data analysis while qualitative data analysis was Conducted on payment reform and grading treatment poli- cy document review as well as key stakeholder interview. Results Out--of--county hospitalization rate declined and self --paying payment proportion reduced after the reform of payment. After grading treatment, both out--of--county hos- pitalization rate and inpatient expenditure declined, while individual payment proportion increased. Conclusions Both payment reform and grading treatment showed a positive role for the control of out--of--county hospitalization rate. Grading treatment reduced hospitalization rate and proportion of NCMS expenditure except for individual payment pro- portion.
出处
《中国农村卫生事业管理》
2016年第4期412-415,共4页
Chinese Rural Health Service Administration
关键词
支付方式改革
县外住院就医
分级诊疗
个人费用
payment reForm
out-- oF-- county hospitalization
grading treatment
individual expenditure
