新农合:实施绩效、发展制约与制度改进路径  

New Rural Cooperative Medical Treatment System:the Achievement Evidences,Development Constraints and System Improvement Paths

作　　者：于卉兰[1] 张乐柱[2] 

机构地区：[1]山东农业大学经济管理学院,山东泰安271018 [2]华南农业大学经济管理学院,广东广州510642

出　　处：《华南农业大学学报（社会科学版）》2009年第3期54-61,共8页Journal of South China Agricultural University(Social Science Edition)

摘　　要：2003年以来,新型农村合作医疗取得了阶段性绩效:农村医保体制基本建立且保障水平逐渐上升,农村居民参合率与覆盖面逐年增加,受益面逐渐扩大,基层医疗卫生资源得以有效利用。存在的发展障碍:合作医疗模式制约可持续性,长期稳定的筹资机制尚未建立,管理人员与费用严重不足,对定点医疗机构缺乏制度性约束,农村特殊群体的医疗保障有待加强,乡镇卫生院服务能力薄弱,制度实施缺乏法律保障等。进而提出了制度改进路径:构建住院统筹与门诊统筹结合的医疗模式,完善新农合运行机制,构建多层次医疗保障体系,以倾斜政策加快农村医疗基础设施建设,建立健全相关法律法规。The new rural cooperative medical treatment system starting in 2003 has achieved periodical achievements： the rural medical insurance system has been basically completed and its guarantee level has been accelerated progressively; the rate of peasants＇ participation and the coverage of the new system has both been inereased year by year; the coverage of cooperative medical treatment beneficiaries has been expanded; and the basic level medical and sanitary resources are utilized efficiently. Nevertheless, there are many factors hampering the development of the new system, such as： the models of cooperative medical treatment have restricted the sustainable development of the new system, the long-term stable capital raising mechanism are not yet established, the management expertise and fees are severely shorted, the lack of institutional constraints for the medical treatment institutions; the medical guarantee for special groups is yet to be strengthened, the weak service ability of the small hospitals of villages and towns, and the lack of legal guarantee for the implementation of the system, etc. Accordingly, this article puts forward the paths for the system improvement： constructing the medical treatment models combined of planned hospitalization and planned outpatient service, completing the operating mechanism of the new system, building up multi-level medical treatment guarantee system, speeding up the fundamental facility construction of the new system with the preferential policies, and completing relative laws and regulations.

关 键 词：新型农村合作医疗 绩效 制约因素 改进路径 

分 类 号：F323.89[经济管理—产业经济]