吉林省新型农村合作医疗“住院低比例报销起付段”措施实施效果分析  

Effectiveness Evaluation on the Implementation of Inpatient Low Compensation for the Limit to Pay in Jilin Province

作　　者：高广颖[1] 闫德胜[2] 沈文生[2] 陈治水[1] 郭欣欣[1] 王蕾[2] 

机构地区：[1]首都医科大学卫生管理与教育学院,北京100069 [2]吉林省卫生厅农卫处,长春130000

出　　处：《中国卫生经济》2012年第1期51-52,53,54,共4页Chinese Health Economics

基　　金：卫生部农卫司吉林省新农合门诊统筹和住院统筹相结合模式运行效果分析项目

摘　　要：目的:总结吉林省新型农村合作医疗制度经验,分析实行"住院低比例报销起付段"对住院率的影响,为全国新型农村合作医疗制度有效运行提供参考和借鉴。方法:采用分层抽样方法抽取13个样本县,对省、县、乡三级医疗卫生机构进行现场调查和数据搜集。结果:新型农村合作医疗门诊统筹与住院低比例报销起付段的结合,有效抑制了住院率的增长,合理调整了县乡两级医疗机构的就医结构,适度规避了"门诊转住院"风险。结论:住院低比例报销起付段新举措的实施具有积极意义,但在推广的过程中也应注意因地制宜和基金风险。Objective： To summarize experiences of the implenlentation of new rural cooperative medical .system （NCMS） in Jilin province, analysis the impact of ＂low compensation for the limit to pay＂ （LCFLTP） on hospitalization rates, provide references for operation of NCMS effectively. Method： Using stratified sampling extracts 13 sample counties, carrying out fiehl survey and data collection on provincial, county and township medical institutes. Result： Integration of outpatient co-ordination and the LCFLTP, restrain the growth of the hospitalization rates effectively, adjust county and township medical demand stnlcture rationally, avoid ＂outpatient transfer to inpatient＂ moderately. Conclusion： The new act of LCFLTP is significant positively, also need to conc, ern tailor measures Io suit local conditions and fund risk when prumotion.

关 键 词：新型农村合作医疗 住院统筹 起付线 低比例报销 

分 类 号：R197.1[医药卫生—卫生事业管理]