县域医共体对新农合参合居民就诊流向的影响分析——以安徽省定远县为例  

Analysis of the impact of county medical alliance on patient flows under the NRCMS:A case study of Dingyuan county of Anhui Province

作　　者：刘双[1,2] 王芳 田淼淼[2] 贾梦[2] 陈凯 赵艳青 蒋祥 谭雯 UU shuang;WANG Fang;TIAN Miao- miao;JIA Meng;CHEN Kai;ZHAO Yan- qing;JIANG Xiang;TAN Wen(Peking Union Medical College,Beijing 100730,China;Institute of Medical Information, Center for Health System and Policy, Chinese Academy of Medical Sciences, Beijing 100020, China;Department of Primary Health Care, National Health and Family Planning Commission , Beijing 100191, China)

机构地区：[1]北京协和医学院,北京100730 [2]中国医学科学院医学信息研究所卫生体系与政策研究中心,北京100020 [3]国家卫生计生委基层卫生司,北京100191

出　　处：《中国卫生政策研究》2018年第4期45-49,共5页Chinese Journal of Health Policy

基　　金：2017年国家卫生计生委基层司委托重点项目;中国医学科学院医学与健康科技创新工程项目(2016-I2M-3-018)

摘　　要：目的:分析安徽省定远县开展县域医共体建设对新农合参合居民就诊流向的影响。方法:开展访谈了解县域医共体主要改革举措,收集2015—2016年新农合平台数据及相关政策文件。结果:2015—2016年参合人员就诊流向发生改变;(1)县域外住院病人减少了3.31%;(2)县域内县乡两级医疗机构门诊、住院人次显著增加,且乡镇卫生院住院人次数增长幅度大于县级医院;村卫生室诊疗人次数下降。3)县域外诊疗费用远高于县域内,且县级医院次均费用增长明显,而乡镇卫生院基本保持不变。结论:县域医共体建设有助于减少县域外住院人次数、减轻新农合基金压力;进一步改善县域就诊流向面临人才短缺、信息化发展滞后等挑战。Objective： This study is conducted to analyze the impact of county medical alliance on patient flows under the NRCMS in Dingyuan county of Anhui province. Methods： data on patient-flow were collected through the NRCMS information platform and related policy documents for 2015—2016,and interviews were conducted to study the main reform practices in the county medical alliance. Results： The patient flow under the NRCMS varied in the way of 1） the total number of inpatients seeking treatment outside of the county decreased by 3. 31%; 2） the treatment volume of county-level hospitals and township health centers were increasing,and the latter one is growing faster than the former,meanwhile,the treatment volume of the village clinics declined,and 3） the hospitalization expenses per inpatient for patients who seek treatment outside the county are much higher than the expenses incurred within the county. Conclusions： the development of county-level medical alliance has influence on patients with common diseases who used to seek treatment by helping to reduce the number of inpatients outside the county and reduce the pressure of the new rural cooperative fund. However,significant problems still exist such as shortage of talented practitioners,and lagging development of information technology system.

关 键 词：县域医共体 新农合 就诊流向 

分 类 号：R197[医药卫生—卫生事业管理]