本文選題：新農(nóng)合 + 住院　； 參考：《中國衛(wèi)生事業(yè)管理》2014年08期

【摘要】：目的:了解新農(nóng)合住院報銷政策的調(diào)整效果,切實(shí)減輕住院患者疾病經(jīng)濟(jì)負(fù)擔(dān),為完善新農(nóng)合制度提供相應(yīng)的政策建議。方法:運(yùn)用SPSS17.0統(tǒng)計軟件對湖北A市2010-2012年新農(nóng)合患者就醫(yī)費(fèi)用數(shù)據(jù)進(jìn)行分析。結(jié)果:政策調(diào)整后,A市就醫(yī)格局合理化,衛(wèi)生資源利用率極大提升;實(shí)際補(bǔ)償比提高,參合農(nóng)民負(fù)擔(dān)減輕,健康意識增強(qiáng)。但是住院量增幅較大,可能存在不合理住院現(xiàn)象,新農(nóng)合基金壓力大;市外就醫(yī)患者實(shí)際補(bǔ)償比仍然較低(45.83%)。結(jié)論:提高基層醫(yī)療機(jī)構(gòu)服務(wù)能力;繼續(xù)發(fā)揮新農(nóng)合的經(jīng)濟(jì)杠桿調(diào)節(jié)作用;加強(qiáng)門診補(bǔ)償,控制住院率,減少不合理的住院;關(guān)注高額費(fèi)用患者,提高實(shí)際補(bǔ)償比;堅(jiān)持動態(tài)管理原則,科學(xué)設(shè)計和調(diào)整新農(nóng)合補(bǔ)償政策。
[Abstract]:Objective: to understand the adjustment effect of the NCMS inpatient reimbursement policy, to reduce the economic burden of the inpatients, and to provide the corresponding policy suggestions for the improvement of the NCMS system. Methods: SPSS 17.0 statistical software was used to analyze the data of medical expenses of NCMS patients from 2010 to 2012 in A City of Hubei Province. Results: after the policy adjustment, the pattern of medical treatment was rationalized, the utilization rate of health resources was greatly improved, the actual compensation ratio was increased, the burden of participating farmers was lightened, and the health awareness was enhanced. However, the increase of hospitalization amount is large, there may be unreasonable hospitalization phenomenon, the pressure of NRCF is great, and the actual compensation ratio of out-city patients is still low (45.83%). Conclusion: improve the service ability of primary medical institutions; continue to play the role of economic leverage of NCMS; strengthen outpatient compensation, control the rate of hospitalization, reduce unreasonable hospitalization, pay attention to patients with high costs, improve the actual compensation ratio; Adhere to the principle of dynamic management, scientific design and adjustment of the new rural cooperative compensation policy.
【作者單位】： 仙桃市新農(nóng)合管理辦公室;湖北省腫瘤醫(yī)院;
【基金】：湖北省衛(wèi)生政策項(xiàng)目“重大疾病保障機(jī)制研究”(編號:ZC2012-3)
【分類號】：R197.1;F842.684;F323.89

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