吉林省新型農村合作醫(yī)療發(fā)展現狀及對策研究
發(fā)布時間：2018-07-16 18:46
【摘要】：【研究背景】 從2003年起，新型農村合作醫(yī)療制度在全國部分縣(市)試點，中央政府根據經濟社會發(fā)展的差異，，將吉林省作為第一批4個試點省份之一。自新農合開展以來，吉林省在方案設計、制度建設與執(zhí)行等方面進行了積極的探索，取得了顯著的成果，新農合覆蓋面不斷擴大，參合率不斷提高，制度不斷鞏固和完善，很大程度上改善了農民的就醫(yī)狀況，減輕了參合農民的醫(yī)療負擔。但是在實施的過程中仍然存在許多問題，為客觀、真實、全面、公正的評價吉林省新型農村合作醫(yī)療制度的發(fā)展狀況，找出存在的問題，提出完善吉林省新型農村合作醫(yī)療制度的對策與建議，已成為當務之急。 【研究目的】 本文通過吉林省和全國各地區(qū)新農合歷年數據的橫向對比研究，近幾年吉林省新農合數據的縱向對比研究，評價吉林省新農合的發(fā)展現狀，分析發(fā)展中存在的問題；借鑒其他國家農村醫(yī)療保障制度和國內典型地區(qū)新農合發(fā)展的經驗，提出對吉林省新農合發(fā)展有益的對策和建議。 【研究方法】 本研究收集了2007～2012年吉林省新農合相關報表、各項制度政策，參閱了2007～2012年《中國衛(wèi)生統(tǒng)計年鑒》和《吉林省國民經濟和社會發(fā)展統(tǒng)計公報》，對吉林省衛(wèi)生資源狀況、新農合開展、基金運行、經辦機構建設等情況進行全面的分析和評價，提出新農合運行過程中出現的問題及對策建議。 【研究結果】 1.吉林省人均衛(wèi)生資源持續(xù)增長。2007～2012年，吉林省人均衛(wèi)生資源量（每千人擁有醫(yī)療機構床位數和衛(wèi)生技術人員）均保持增長趨勢，且高于同期全國平均水平，但城鄉(xiāng)衛(wèi)生資源分布不均衡。 2.吉林省新農合自發(fā)展以來取得了顯著的成果。2007～2012年，參合人數由1046.8萬人增加到1328.2萬人，參合率由82.1%增加到99.4%，籌資總額由53656.5萬元增加到386000.0萬元、人均籌資額由51.3元增加到290.6元，但人均籌資額低于全國平均水平。門診實際補償比、住院實際補償比、補償封頂線均有顯著提高。2012年門診實際補償比和住院實際補償比分別為37.0%和52.5%，分別比2007年提高了15.3%和23.5%，但低于同期全國平均水平；補償封頂線由2007年的3萬元提高到2012年的8萬元，個別地區(qū)達到了10萬元。 3.縣級經辦機構每實有人員管理參合人數較大，且各地區(qū)之間差距較大。2011年，吉林省縣級經辦機構平均每實有人員管理參合人數為24112.1，最大的榆樹市為140651，最小的吉林市高新區(qū)為1263，兩者相差111.4倍。 4.參合患者在縣級以上醫(yī)療機構住院費用較高。2012年，次均住院費用為10009.1元，次均自費費用為5686.2元，占當年農民人均純收入的66.1%。 5.參合患者選擇在縣級醫(yī)療機構和縣級以上醫(yī)療機構住院的比重呈上升趨勢，在鄉(xiāng)鎮(zhèn)級醫(yī)療機構住院的比重不斷下降。2007～2012年，縣級醫(yī)療機構住院人次占住院總人次的比例由45.6%上升到54.1%，縣級以上醫(yī)療機構由18.4%上升到30.4%，鄉(xiāng)鎮(zhèn)級醫(yī)療機構由36.0%下降到15.5%。 【研究結論】 吉林省新農合制度自開展以來，運行平穩(wěn)，并取得了顯著的成果。但也存在著一些問題。第一，籌資標準的確定欠科學且籌資渠道單一。第二，對于基金的使用缺乏合理的預算。第三，門診統(tǒng)籌發(fā)展較慢。第四，縣級經辦機構配備工作人員數量不合理。第五，住院就醫(yī)流向不合理，且有逐年加重的趨勢。
[Abstract]:[research background]
Since 2003, the new rural cooperative medical system has been pilot in some counties (cities) in the country. According to the differences in economic and social development, the central government has taken Jilin as one of the first 4 pilot provinces. Since the development of the new agricultural cooperation, the Jilin province has made a positive exploration in the design of the scheme, the construction and implementation of the system, and has made remarkable achievements. With the expansion of the coverage of the NCMS, the continuous improvement of the participation rate and the continuous consolidation and improvement of the system, the medical conditions of the farmers were improved to a great extent and the medical burden of the farmers were reduced. However, there are still many problems in the process of implementation, and the new rural cooperative medical system in Jilin province is evaluated objectively, truly, completely and impartially. The development situation, finding out the existing problems and putting forward the countermeasures and suggestions to improve the new rural cooperative medical system in Jilin have become a top priority.
[purpose]
In this paper, through the comparative study of the data of the new rural cooperation years in Jilin and the whole country, the longitudinal comparison of the new agricultural cooperation data in Jilin Province in recent years, evaluation of the development status of the new agricultural cooperation in Jilin Province, the analysis of the existing problems in the development, and the experience of the rural medical security system in other countries and the development of the new agricultural cooperation in the typical areas of the country. Some useful countermeasures and suggestions are put forward for the development of Jilin new rural cooperative medical system.
[research methods]
In this study, the report of the new agricultural cooperation (nncms) in Jilin province was collected for 2007~2012 years, and the system policies were collected, and the 2007~2012 year "China Health Statistics Yearbook" and "the national economic and social development statistical bulletin of Jilin province" were reviewed. The situation of the health resources in Jilin Province, the development of the new agricultural cooperation, the operation of the fund and the construction of the agencies were reviewed and reviewed. Price, put forward the problems and Countermeasures in the operation of the new rural cooperative medical system.
[results]
1. the per capita health resources in Jilin province continued to increase from.2007 to 2012. The per capita health resources in Jilin province (each thousand people with medical institutions and health technicians) kept growing, and higher than the national average in the same period, but the distribution of urban and rural health resources was uneven.
2. since the development of NCMS in Jilin province has achieved remarkable results since its development from.2007 to 2012, the number of participants increased from 10 million 468 thousand to 13 million 282 thousand, the rate of participation increased from 82.1% to 99.4%, the total amount of financing increased from 536 million 565 thousand yuan to 3 billion 860 million yuan, and the per capita financing amount increased from 51.3 yuan to 290.6 yuan, but the per capita fund-raising was lower than the national average. The actual compensation ratio, the actual compensation ratio in the hospital and the compensation capping line significantly improved the actual compensation ratio and the actual hospitalization compensation ratio of 37% and 52.5% in.2012 years, respectively, increased by 15.3% and 23.5% in 2007, respectively, but lower than the national average in the same period; the compensation capping line was raised from 30 thousand yuan in 2007 to 80 thousand yuan in 2012, in some areas. Up to 100 thousand yuan.
3. the number of personnel management participation in the 3. county-level agencies is larger, and the gap between the regions is larger in.2011 years. The average number of personnel management participation in the county level agencies in Jilin province is 24112.1, the largest elm city is 140651, the smallest Jilin high tech Zone is 1263, and the difference between the two is 111.4 times.
4. the hospitalization expenses of the medical institutions at the county level above the county level were higher for.2012 years, and the average cost of hospitalization was 10009.1 yuan, and the cost of self-charge was 5686.2 yuan, which accounted for 66.1%. of the per capita net income of the year.
5. the proportion of hospitalized patients in county-level medical institutions and medical institutions above the county level is on the rise. The proportion of hospitalization in township level medical institutions is decreasing from.2007 to 2012. The proportion of inpatients in the county level medical institutions increased from 45.6% to 54.1%, and the medical institutions above the county level increased from 18.4% to 30.4%. The level of medical institutions dropped from 36% to 15.5%.
[Conclusion]
Since the new rural cooperative system of Jilin province has been carried out, its operation has been smooth and remarkable achievements have been achieved. However, there are also some problems. First, the financing standards are not scientific and the financing channels are single. Second, the lack of reasonable budget for the use of funds. Third, the overall development of out-patient services is slow. Fourth, county-level agencies are equipped with the number of staff. Unreasonable. Fifth, the inflow of hospitalization is unreasonable, and there is a trend of increasing year by year.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R197.1;F323.89;F842.684
本文編號：2127299
[Abstract]:[research background]
Since 2003, the new rural cooperative medical system has been pilot in some counties (cities) in the country. According to the differences in economic and social development, the central government has taken Jilin as one of the first 4 pilot provinces. Since the development of the new agricultural cooperation, the Jilin province has made a positive exploration in the design of the scheme, the construction and implementation of the system, and has made remarkable achievements. With the expansion of the coverage of the NCMS, the continuous improvement of the participation rate and the continuous consolidation and improvement of the system, the medical conditions of the farmers were improved to a great extent and the medical burden of the farmers were reduced. However, there are still many problems in the process of implementation, and the new rural cooperative medical system in Jilin province is evaluated objectively, truly, completely and impartially. The development situation, finding out the existing problems and putting forward the countermeasures and suggestions to improve the new rural cooperative medical system in Jilin have become a top priority.
[purpose]
In this paper, through the comparative study of the data of the new rural cooperation years in Jilin and the whole country, the longitudinal comparison of the new agricultural cooperation data in Jilin Province in recent years, evaluation of the development status of the new agricultural cooperation in Jilin Province, the analysis of the existing problems in the development, and the experience of the rural medical security system in other countries and the development of the new agricultural cooperation in the typical areas of the country. Some useful countermeasures and suggestions are put forward for the development of Jilin new rural cooperative medical system.
[research methods]
In this study, the report of the new agricultural cooperation (nncms) in Jilin province was collected for 2007~2012 years, and the system policies were collected, and the 2007~2012 year "China Health Statistics Yearbook" and "the national economic and social development statistical bulletin of Jilin province" were reviewed. The situation of the health resources in Jilin Province, the development of the new agricultural cooperation, the operation of the fund and the construction of the agencies were reviewed and reviewed. Price, put forward the problems and Countermeasures in the operation of the new rural cooperative medical system.
[results]
1. the per capita health resources in Jilin province continued to increase from.2007 to 2012. The per capita health resources in Jilin province (each thousand people with medical institutions and health technicians) kept growing, and higher than the national average in the same period, but the distribution of urban and rural health resources was uneven.
2. since the development of NCMS in Jilin province has achieved remarkable results since its development from.2007 to 2012, the number of participants increased from 10 million 468 thousand to 13 million 282 thousand, the rate of participation increased from 82.1% to 99.4%, the total amount of financing increased from 536 million 565 thousand yuan to 3 billion 860 million yuan, and the per capita financing amount increased from 51.3 yuan to 290.6 yuan, but the per capita fund-raising was lower than the national average. The actual compensation ratio, the actual compensation ratio in the hospital and the compensation capping line significantly improved the actual compensation ratio and the actual hospitalization compensation ratio of 37% and 52.5% in.2012 years, respectively, increased by 15.3% and 23.5% in 2007, respectively, but lower than the national average in the same period; the compensation capping line was raised from 30 thousand yuan in 2007 to 80 thousand yuan in 2012, in some areas. Up to 100 thousand yuan.
3. the number of personnel management participation in the 3. county-level agencies is larger, and the gap between the regions is larger in.2011 years. The average number of personnel management participation in the county level agencies in Jilin province is 24112.1, the largest elm city is 140651, the smallest Jilin high tech Zone is 1263, and the difference between the two is 111.4 times.
4. the hospitalization expenses of the medical institutions at the county level above the county level were higher for.2012 years, and the average cost of hospitalization was 10009.1 yuan, and the cost of self-charge was 5686.2 yuan, which accounted for 66.1%. of the per capita net income of the year.
5. the proportion of hospitalized patients in county-level medical institutions and medical institutions above the county level is on the rise. The proportion of hospitalization in township level medical institutions is decreasing from.2007 to 2012. The proportion of inpatients in the county level medical institutions increased from 45.6% to 54.1%, and the medical institutions above the county level increased from 18.4% to 30.4%. The level of medical institutions dropped from 36% to 15.5%.
[Conclusion]
Since the new rural cooperative system of Jilin province has been carried out, its operation has been smooth and remarkable achievements have been achieved. However, there are also some problems. First, the financing standards are not scientific and the financing channels are single. Second, the lack of reasonable budget for the use of funds. Third, the overall development of out-patient services is slow. Fourth, county-level agencies are equipped with the number of staff. Unreasonable. Fifth, the inflow of hospitalization is unreasonable, and there is a trend of increasing year by year.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R197.1;F323.89;F842.684
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