新型农村合作医疗筹资与补偿均等化——基于东部X省的实证分析  

The equality of financing and compensation of New Rural Cooperative Medical Scheme: An empirical analysis in an eastern province in China

作　　者：王小合[1] 钱宇[1] 黄仙红[1] 张萌[1] 张亮[2] 

机构地区：[1]杭州师范大学医学院,浙江杭州310036 [2]华中科技大学同济医学院医药卫生管理学院,湖北武汉430030

出　　处：《中国卫生政策研究》2014年第6期28-34,共7页Chinese Journal of Health Policy

基　　金：浙江省社科规划课题(12JCSH05YB);浙江省医药卫生科技计划项目(2011KYA125);教育部人文社科研究基金(09YJC630054)

摘　　要：目的:分析东部X省不同经济类型区域新农合均等化程度及趋势,为各地推进地方财政体制机制改革、促进新农合均等化发展提供借鉴及参考。方法:选取东部典型X省为现场,采集2005—2011年该省所有涉农县新农合实际运行的数据资料,运用差异系数、平均系数、泰尔指数法进行综合测评。结果:该省三类区域新农合人均筹资水平尚未达到底线均等。2005—2011年全省及三类区域间和区域内新农合参合覆盖面、筹资水平及住院实际补偿待遇差异,总体上均呈现逐年下降趋势,欠发达区域均等化程度显著高于其它两类区域。结论:该省及三类区域新农合均等化呈现逐年优化改善并趋稳态势;省管县财政体制机制创新为其均等化发展提供了有利环境和形成条件;建议构建省管县财政分类转移支付促进新农合均等化发展的动态预测模型,进一步优化调整筹资机制;推进新农合省级统筹管理,以促进其均等化发展。Objective： To analyse the degree of equality of New Rural Cooperative Medical Scheme （NRCMS） in different economic regions. We provide a reference for equal development of the NRCMS and the reform of the political system and mechanism under the provincial-controlled county fiscal system. Methods： A typical province was chosen with provincial-controlled county fiscal system was fully implemented several years. We collected data on coverage, financing and compensation for the NRCMS from 2005 to 2011. We used the variable coefficient, uniformity coefficient, Theil Index for comprehensive evaluation. Results： Per capita financing has not reached the bottom line. From 2005 to 2011, inter-re- gional and intra-regional variation coefficient, Theil index of service coverage, financing level and hospital actual compen- sation has declined year by year. The degree of inequality in economically developed regions was greater than in less eco- nomically developed regions and economic medium region. Conclusion： The degree of equalization of the NRCMS in the province continuously improved. Innovation of provincial-controlled county fiscal system and mechanism provides a favora- ble environment and forming conditions for equalizing the development of the NRCMS. The paper suggested exploring and building fiscal classification step transfer payment institution and dynamic prediction model of the NRCMS, further optimi- zing financing mechanism, promoting the provincial management system of the NRCMS as soon as possible in order to pro-mote the equalization development.

关 键 词：省管县财政体制 新农合 筹资 补偿 均等化 

分 类 号：R197[医药卫生—卫生事业管理]