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目的:了解某地农民疾病风险发生规律与特点,研究新农合管理决策措施。方法:利用关联规则分析与疾病频率和疾病费用相关的强关联规则。结果:与疾病频率相关联的强规则是:住院分娩=>女性、骨折、阑尾疾病=>男性,年龄≥65岁=>循环系统疾病、年龄<15岁=>消化系统疾病和年龄≤5岁=>呼吸系统疾病等;与住院费用相关的强规则是:(损伤、中毒)U(县级住院)=>高级别费用、地市级以上的住院=>高级别费用;与补偿后较高个人负担相关的规则是:(年龄<0.5岁)U(性别=男)=>(报销后自负费用>2 500元)。结论:当地新农合管理应加强高危人群的重点疾病风险控制、完善转诊(会诊)制度、扩大新农合婴幼儿用药报销范围等是降低新农合基金支出、降低个人疾病风险应慎重考虑的措施。
OBJECTIVE: To understand the regularity and characteristics of disease risk in some farmers and to study the decision-making measures of NCMS. Methods: Using association rules to analyze strong association rules associated with disease frequency and disease costs. RESULTS: Strong rules associated with disease frequency were: hospital delivery => female, fracture, appendicitis => male, age> 65 years => circulatory disease, age <15 years => digestive diseases and age <5 years => Respiratory diseases, etc .; strong rules related to hospitalization costs are: (injury, poisoning) U (county hospitalization) => high-level expenses, higher than city-level hospitalization => high-level expenses; Personal burden related rules are: (age <0.5 years old) U (gender = male) => (self-reimbursement after reimbursement> 2 500 yuan). Conclusion: The local NCMS should strengthen the risk control of key diseases in high-risk groups, improve referral (consultation) system, and expand the scope of reimbursement for new-maternal and infant medicine so as to reduce the expenditure of new rural cooperative medical funds and reduce the risk of individual diseases should be carefully considered The measure.