【摘要】：目的：通過對吉林省醫(yī)保體系的歷史發(fā)展和現(xiàn)狀進行調(diào)查、分析，結(jié)合吉林省的實際情況，參考國際上的先進經(jīng)驗和國內(nèi)其它省市試點的經(jīng)驗，探索適合我省實際情況的醫(yī)保城鄉(xiāng)統(tǒng)籌的機制。 方法：本研究通過文獻研究法、訪談法等方法對吉林省醫(yī)療保險體系現(xiàn)狀進行調(diào)查研究，采用描述性分析、秩和檢驗等統(tǒng)計方法對肺癌患者數(shù)據(jù)、2007-2012年吉林省新農(nóng)合患者在不同級別醫(yī)療機構(gòu)就醫(yī)的數(shù)據(jù)進行處理，采取文獻研究法和非結(jié)構(gòu)型訪談法對長春市朝陽區(qū)的試點情況進行研究。 結(jié)果：城鎮(zhèn)職工醫(yī)療保險的各方面待遇遠高于其它醫(yī)保。城鎮(zhèn)居民醫(yī)療保險和新農(nóng)合在總費用、住院天數(shù)、自費費用、自費比例、報銷費用、報銷比例等方面比較接近，無顯著差異。城鄉(xiāng)統(tǒng)籌試點的朝陽區(qū)為新農(nóng)合患者的醫(yī)療與報銷提供了方便，但是降低了患者的待遇。2007-2012年，吉林省新農(nóng)合患者在各級醫(yī)療機構(gòu)就醫(yī)時，住院次均費用、住院次均自費費用、補償比例逐年提升。在基層醫(yī)療機構(gòu)就醫(yī)的患者逐年減少，到縣級及縣級以上醫(yī)療機構(gòu)就醫(yī)的患者逐年增多�；鶎俞t(yī)療機構(gòu)在醫(yī)保基金中所占的份額逐年遞減，縣級醫(yī)療機構(gòu)所占份額逐年上升，縣以上醫(yī)療機構(gòu)所占份額基本保持不變。 結(jié)論：實施醫(yī)保城鄉(xiāng)統(tǒng)籌，可以解決省內(nèi)流動人口醫(yī)保關系的轉(zhuǎn)移接續(xù)問題；可以縮短城鄉(xiāng)差距，，體現(xiàn)公共服務均等化的理念；可以加強對醫(yī)�；鸬谋O(jiān)管和對騙保行為的打擊力度；可以擴大省內(nèi)各統(tǒng)籌地區(qū)的醫(yī)�；鹨�(guī)模。
[Abstract]:Objective: through the investigation and analysis of the historical development and present situation of the medical insurance system in Jilin Province, combined with the actual situation of Jilin Province, referring to the advanced international experience and the experience of other provinces and cities in China, Explore the medical insurance urban and rural overall planning mechanism suitable for the actual situation of our province. Methods: this study investigated the present situation of medical insurance system in Jilin Province by means of literature research and interview, and used descriptive analysis, rank sum test and other statistical methods to analyze the data of patients with lung cancer. From 2007 to 2012, the data of NCMS patients in different levels of medical institutions in Jilin Province were processed, and the pilot situation of Chaoyang District of Changchun City was studied by means of literature research and unstructured interview. Results: the treatment of medical insurance for urban workers was much higher than that of other medical insurance. There is no significant difference between urban residents' medical insurance and NCMS in terms of total expenses, hospitalization days, self-expenses, proportion of self-expenses, reimbursement ratio and so on. Chaoyang District, which is a pilot project in urban and rural areas, provides convenience for the medical treatment and reimbursement of NCMS patients, but reduces the treatment of patients. From 2007 to 2012, the average cost of hospitalization of NCMS patients in medical institutions at all levels in Jilin Province was average. Hospitalization expenses are all at their own expense, and the proportion of compensation is increasing year by year. The number of patients seeking medical treatment in primary medical institutions is decreasing year by year, and the number of patients going to county-level and above medical institutions is increasing year by year. The share of primary medical institutions in medical insurance funds is decreasing year by year, the share of county-level medical institutions is increasing year by year, and the share of medical institutions above county level is basically unchanged. Conclusion: the implementation of medical insurance as a whole between urban and rural areas can solve the problem of transferring and continuing the relationship of medical insurance for floating population in the province, shorten the gap between urban and rural areas, and embody the concept of equal public service. It can strengthen the supervision of health insurance funds and crack down on insurance fraud, and can expand the scale of health insurance funds in all areas of the province.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R197.1;F842.684

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