从云南省新农合数据看医改成效  

Achievements of health reform from the perspective of new rural CMS data in Yunnan province

作　　者：杜远见[1] 杨添懿 段勇[1] 黄兴黎 车刚 谢馨莹 姜明[3] 温跃生[1] 陈平[1] 王燕[1] 杜茸茸[1] 杨景泽 李鹏 宁永功[4] 白志文 DU Yuan-jian YANG Tian-yi DUAN Yong et al(Office of NRCMS Information Management, Health Education Institution, Kunming ,Yunnan 650118, China)

机构地区：[1]云南省健康教育所新农合信息管理办公室,云南昆明650118 [2]云南省卫计委农村卫生管理处,云南昆明650200 [3]云南省医学信息研究所,云南昆明650200 [4]云南省地方病防治所,云南昆明650200

出　　处：《中国农村卫生事业管理》2016年第11期1368-1371,共4页Chinese Rural Health Service Administration

摘　　要：目的:通过对云南省新农合运行情况进行分析,总结医改成效,探索进一步完善新农合制度的措施和方法。内容与方法:对2004年、2009年到2015年新农合统计信息报表用Excel进行统计分析,计算各年度基金到位情况、参合农民受益率、次均补偿费用、实际补偿比等指标,对新农合运行情况、农民受益情况进行对比分析,总结医改成效。结果:医改启动以来,新农合基金盘子不断加大、参合农民的保障水平提高幅度较医改前大、保障范围也进一步扩大,重大疾病提高补偿水平、县乡级免费住院分娩、省内异地就医即时结报、由新农合基金支出的大病补充保险覆盖所有参合农民,这些医改实实在在的成效减轻了参合农民的医疗负担、方便了参合农民、减少了大病患者因病致贫、因病返贫的发生。结论:从云南省新农合制度运行情况可以看出医改取得了实实在在的成效。Objective To summarize the effects of health reform and to explore the measures for further improvement in the new rural CMS based on the analysis of new rural cooperative medical operation in Yunnan Province.Methods Statistics reports in year 2004,2009 to 2015were analyzed with Excel.We calculated the annual fund,benefit rates of participating farmers,compensation,compensation ratio and other indicators.Besides,we analyzed the operation of new rural cooperative medical scheme and benefits gained by farmers,and summarized the effectiveness of health care reform.Results Ever since the implementation of the new health care reform,CMS fund has constantly increased,and the support level and support scope of participating farmers has greatly improved.What＇s more,the compensation for serious diseases is increased,hospitalized delivery in township and county hospitals is free,instant settlement is conducted for medical consultation in another city,and complementary insurance for serious diseases covers all participating farmer.All of these measures reduce the financial burdens of the participants,bring them convenience and avoid poverty due to sickness.Conclusion Health reform of new rural CMS in Yunnan province has achieved tangible results.

关 键 词：新农合 医改 成效 

分 类 号：R197.1[医药卫生—卫生事业管理]