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通过在京郊农村的问卷调查和个案访谈发现:医疗体制环境是农户医疗需求的最主要约束因素。由于农村社区医疗服务的缺位和农村社区外医疗服务的昂贵,使农户患病时陷入了“能花小钱就治好时没处治,花大钱才能治好时治不起”的困境。新型合作医疗制度(NCMS)由于“只保大病受益机会太小”、“报销比例太低解决不了大问题”、“报效手续太繁琐”和“看病不自由没有选择权”等制度方面的约束,对实现农户医疗需求的作用十分有限,而且因“先付后报”的制度门槛,富裕农户的受益比例要高于贫困农户。
Through the questionnaire survey and case interview in the rural areas of Beijing suburbs, it is found that the medical system environment is the most important constraint factor for the farmers’ medical needs. Due to the lack of medical services in rural communities and the high cost of medical services outside rural communities, farmers are caught in the plight of “can not cure when they can spend a small amount of money and can not cure when they spend a lot of money.” The new cooperative medical system (NCMS) is constrained by the institutional constraints such as “too little chance of benefiting only the serious illness,” too little reimbursement can not solve the big problem, “too complicated the procedures for applying for the service,” and “no freedom to see a doctor. The effect on the medical needs of farmers is very limited, and due to the system threshold of ”prepay after report", the proportion of benefit of affluent peasants is higher than that of poor peasants.