新型农村合作医疗制度对医疗服务分流的影响机制研究  

Study on the influence mechanism of new rural cooperative medical system to the patient flow

作　　者：许利刚[1] 尹爱田[1] 井珊珊[1] 

机构地区：[1]山东大学卫生管理与政策研究中心,山东济南250012

出　　处：《中国卫生事业管理》2012年第3期213-215,共3页Chinese Health Service Management

摘　　要：我国基本医疗服务过多地集中于高层级医疗机构而不能向基层合理分流。新农合制度对引导患者合理就医流向起到了一定作用,但引导机制仍存在不足之处,如起付线和补偿比缺乏科学精算、分级补偿比与新农合"大病救治"原则相矛盾以及补偿范围还不完善等问题,因此,应在加强基层医疗机构服务能力建设的基础上,更科学地计算起付线和补偿比,以疾病的性质来区分不同级别医院的补偿比,完善补偿范围。More basic medical services are provided at high level medical institutions than at the low level medical institu- tions. The new rural cooperative medical system （NRCMS） plays a role in instructing the patients to choose hospitals rationally. But there exist many deficiencies, such as ,the base line of medical reimbursement and the compensation proportion are not calcu- lated in a scientific way, there is a conflict between compensation proportion and the principle of the NRCMS, and the compensa- tion range is not complete. So the basic medical services should be strengthened at the low level medical institutions. Then the base line of medical reimbursement and the compensation proportion should be calculated in a scientific way, set up different com- pensation proportions based on the nature of the diseases, and improve the compensation range.

关 键 词：新型农村合作医疗 服务分流 机制 

分 类 号：R197.1[医药卫生—卫生事业管理]