摘要
目的了解新型农村合作医疗(新农合)运行及住院补偿情况,为完善新农合政策提供理论参考。方法收集广西河池市2011~2014年新农合统计信息报表数据,采用描述性流行病学分析方法,分析2011~2014年参合情况、基金筹集、基金支出、基金使用率、住院费用及住院补偿构成。结果新农合的参合率和基金使用率逐年稳步提高,在2014年分别达到98.88%和76.80%。2011年至2014年,基金筹集以财政拨款为主,占58.91%~67.44%;基金支出以住院补偿支出为主,占79.80%~85.31%;门诊补偿人次最多(1 596 471~3 293 581人次),但住院次均补偿最高(1 251.51~2 087.32元)。在各级医疗机构中,县外医疗机构的住院总医疗费用最高,而县级医疗机构住院补偿费用较高;乡级医疗机构的住院补偿比例最高,而县外级医疗机构的住院补偿比例最低。住院补偿人次主要集中在县级和乡级医疗机构,但县级医疗机构获得补偿人次占总体比例逐年增加,而乡级医疗机构所占比例呈下降趋势。结论新农合总体运行良好,但仍需要进一步提高基金使用率及调整住院补偿方案。
Objective To learn the operation and hospital reimbursement of New Rural Cooperative Medical System,thereby to provide the theoretical references to the improvement of New Rural Cooperative Medical System. Methods The statistical information and report data of New Rural Cooperative Medical System in Hechi City of Guangxi were collected from 2011 to 2014. Descriptive epidemiological analysis was used to analyze the participation of New Rural Cooperative Medical System, fund raising, fund expenditure, fund utilization rate,hospitalization expense and the composition of hospital reimbursement from 2011 to 2014. Results The participation rate of New Rural Cooperative Medical System and the utilization rate of the fund increased year by year steadily and reached 98.88% and 76.80% respectively in 2014. From 2011 to 2014, govenament appropriation was the main source of the fund-raising（ accounting for 58.91% -67.44% ）, and the hospital reimbursement was the main expense of the fund （ accounting for 79.80% - 85.31% ）. The person-time reimbursement of the outpatient was the highest（ 1 596 471 -3 293 581 person-time）, but the reimbursement per person of hospitalization was the highest （1 251.51 -2 087.32 yuan） from 2011 to 2014. Among medical institutions with different levels,the total medical cost in the hospital outside the county was the highest, but the hospital reimbursement was higher in the county hospital. The highest and lowest hospital reimbursement proportions were observed in the town hospital and the hospital outside the county respectively. The persons obtaining hospital reimbursement were mainly from county hospital and town hospital. But the ratio of person-time reimbursement in the county hospital to the total person-time reimbursement increased year by year, and the proportion of town hospital tended to decline. Conclusion New Rural Cooperative Medical System runs well as a whole,but it is still necessary to further raise fund utilization rate and adjust the plan of the hospital reimburse
出处
《广西医学》
CAS
2017年第5期678-681,共4页
Guangxi Medical Journal
关键词
新型农村合作医疗
基金
住院补偿
河池市
广西
New Rural Cooperative Medical System, Fund, Hospital reimbursement, Hechi City, Guangxi
