黑龙江省新型农村合作医疗门诊医保支付效果及存在问题研究  

Research on the Effect and Existing Problems of the Outpatient Insurance Payment of New Rural Cooperative Medical System in Heilongjiang

作　　者：李恒[1] 梁民琳[2] 赵荣章 谭振宇[1] 王璟涛 高蕾[1] 

机构地区：[1]哈尔滨医科大学公共卫生学院管理学教研室,哈尔滨150081 [2]黑龙江省卫生厅农卫处,哈尔滨150090

出　　处：《中国卫生经济》2013年第12期46-48,共3页Chinese Health Economics

基　　金：黑龙江省发展和改革委员会医改办研究项目(hljfgwygb2012_016)

摘　　要：目的:探索黑龙江省新型农村合作医疗门诊医保支付效果及存在问题。方法:针对60个地区合管办负责人的问卷调查结果,通过探索性因子分析得出门诊支付效果和存在问题的分类;采用t检验对分类后各项目得分进行比较;采用秩和检验对不同地区医保支付效果和存在问题得分比较。结果:支付效果分为服务质量和费用控制效果,存在问题分为经办机构和医疗机构存在的问题,并且其得分差异(P<0.05),均具有统计学意义。不同地区的农民年均收入各项得分、不同支付方式地区的各项得分比较(P<0.05),具有统计学意义。结论:有效加强医保支付的费用控制,提高农民实际受益水平;改善经办机构条件,加快医保支付方式改革;充分调动定点医疗机构的积极性,提高医院服务质量。Objective： To explore the effect and problems of the outpatient insurance payment of new rural cooperative medical system in Heilongjiang. Methods： Based on the questionnaires from 60 office managers in different areas, getting the classification of outpatients＇ payment effect and problems through explore factor analysis; comparing scores of all items after using t-test; comparing scores of effect and existing problems of insurance payment in different areas by using tank sum test method. Results： The effect is divided into service quality and cost control. Existing problems are divided into the＇ problems of agencies and medical institutions. The difference of scores （P〈O.05） is statistically significant. The scores of farmers＇ average annual income in the agency＇s problem and the differences of four items＇scores in different payment areas （P〈O.05）, are statistical Significant. Conclusion： Effectively strengthening the payment control, improving the farmers ＇actual beneficial levels; improving working condition of agencies, increasing the reform of insurance payment; arousing the enthusiasm of the medical institution and improving the quality of hospital＇ s services.

关 键 词：新型农村合作医疗 门诊支付 黑龙江 

分 类 号：R197.1[医药卫生—卫生事业管理]