提高参合农民实际住院补偿比的策略研究  

The Research of Strategy about Increase the Ratio of Participation Farmers' Actual Hospital Compensation

作　　者：李芳冰[1] 田庆丰[1] 蒋小彬[1] 

机构地区：[1]郑州大学公共卫生学院,郑州大学卫生发展研究中心,河南郑州450000

出　　处：《中国卫生事业管理》2014年第2期130-132,共3页Chinese Health Service Management

基　　金：2012年度河南省医学科技攻关项目“新型农村合作医疗对农民健康作用研究”(编号:201204050)

摘　　要：目的:通过描述郏县新农合住院补偿情况,分析影响参合农民实际补偿比的主要因素,为提高参合农民住院补偿比提供意见和建议。方法采用描述性分析对郏县新农合的基金筹资情况、住院患者流向、次均住院费用、实际补偿情况进行分析。结果 2008-2012年郏县新农合基金支出逐年增加,但次均住院费用增长较快,住院患者流向不合理,参合农民的实际补偿比依旧偏低,参合农民负担依然较重。结论合理引导患者流向、控制定点医疗机构的目录外用药和诊疗项目、控制医疗费用不合理上涨及住院率的非正常提高。Objective To analyze the main factors that influence the hospital compensation ratio of the new rural cooperative medical system and provide the suggestions to improve the ratio of the NRCM hospital compensation. Methods The condition of the fund financing,inpatient flow, average hospitalization expenses, and the actual compensation of the NRCS in Jiaxian were analy- sised by the descriptive analysis. Results The expenditure of fund of Jiaxian NRCM increased year by year, but the average hospi- talization expenses of hospitalized patients growed rapidly. The flowing direction was unreasonable,the hospital compensation ratio of the farmers participated in the NRCM was still low,and farmers＇burden was still heavy in 2008 -2012 years. Conclusion leading a reasonable guide of patient flow and controlling the using of Medication and treatment project beyond the catalogue in the desig- nated medical institutions was needed to contral the unreasonable medicine expense rising and abnormal hospitalization rates in-crease.

关 键 词：新型农村合作医疗 实际住院补偿比 住院患者流向 次均住院费用 

分 类 号：R197.1[医药卫生—卫生事业管理]