论文部分内容阅读
目的:对甘肃省2010—2015年新农合住院率、患者流向和费用负担等进行分析,探讨住院费用过快上涨的原因,发现新农合制度存在的问题。方法:从省新型农村合作医疗管理中心及华东公司提取2010—2015年新农合住院相关数据以及年度报表,分析方法采用卡方分析和描述性统计分析。结果:2010—2015年新农合住院率由6.37%提高到11.85%(χ2=503 005.45,P=0.000);流向县外医疗机构病人明显,县级医疗机构由41.05%提高到52.08%(χ2=103 245.25,P=0.000)。2010—2015年县外医疗机构住院费用最高为58%,乡级最少为7.53%。2010—2015年乡级、县级、县外医疗机构平均补偿比例分别为79.25%、66.30%和49.52%。结论:甘肃省新农合在住院服务利用、补偿费用不断提高等方面取得一定成效的同时,也存在患者就医流向不合理,补偿人次和补偿费用主要流向县及县外医疗机构,应遏制医疗费用过快增长,不断提高补偿水平,合理引导患者就医流向。
OBJECTIVE: To analyze the hospitalization rate, patient flow and cost burden of NRCMS in Gansu Province in 2010-2015 so as to explore the reasons for the rapid increase of hospitalization expenses and to find out the problems existing in NCMS. Methods: The data and annual reports of NRCMS from 2010 to 2015 were extracted from Provincial New Rural Cooperative Medical Care Management Center and East China Company. The analysis methods were chi-square analysis and descriptive statistical analysis. Results: The rate of new rural cooperative medical institutions was increased from 6.37% to 11.85% (χ2 = 503 005.45, P = 0.000) in 2010-2015. The number of medical institutions outside the county was significantly higher from 41.05% to 52.08% (χ2 = 103 245.25, P = 0.000). From 2010 to 2015, the highest cost of hospitalization for medical institutions outside the county is 58%, and the lowest among townships is 7.53%. From 2010 to 2015, the average compensation rate of medical institutions at the township, county and county levels was 79.25%, 66.30% and 49.52% respectively. Conclusions: While NRCMS in Gansu Province has achieved certain results in utilization of hospital services and continuous improvement of compensation fees, the current flow of medical treatment to hospitals is still unreasonable. Compensation rates and compensation fees mainly flow to medical institutions outside counties and counties, and medical expenses should be checked Too rapid growth, continue to raise the level of compensation, reasonable guide the patient flow of medical treatment.