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目的:通过分析城乡医保一体化模式下,2012—2014年长春市朝阳区新型农村合作医疗住院患者的就诊和医疗费用流向情况,探讨存在的主要问题并提出相应的对策。方法:对2012—2014年长春市朝阳区新型农村合作医疗患者在各级医疗机构的住院人次构成比、次均住院费用、次均个人自费和基金使用构成比等进行比较。结果:2012—2014年分流到省级和市级医院的住院人次、费用和新型农村合作医疗补偿费用逐年增加,2014年省级和市级医院住院人次分别为38.11%和42.51%。2012—2014年各级医院住院人次由高到低依次为市级、省级、区级和乡级。参合农民次均住院费用和次均个人自费由高到低依次为省级、市级、区级和乡级医院。2012—2014年新型农村合作医疗基金分流数额由高到低依次为省级、市级、区级和乡级医院。结论:城乡医保一体化模式下,长春市朝阳区参合农民的住院人次、住院费用和住院补偿费用分流到区级和乡镇级医院的比例逐年减少,次均住院补偿比在省级医院最高。
OBJECTIVE: To analyze the flow of medical treatment and medical expenses of inpatients of new-type rural cooperative medical care in Chaoyang District of Changchun City during 2012-2014 under the integrated urban-rural healthcare insurance model, discuss the main problems and propose corresponding countermeasures. Methods: To compare the inpatient composition, the average hospitalization cost, the individual self-payment and the composition ratio of funds used in the new-type rural cooperative medical system in Chaoyang District, Changchun, 2012-2014. Results: In 2012-2014, the expenses of hospitalization and compensation for new-type rural cooperative medical care patients diverted to provincial and municipal hospitals increased year by year. In 2014, the provincial and municipal hospitals accounted for 38.11% and 42.51% respectively. From 2012 to 2014, the number of inpatient visits at all levels of hospitals was from city to province, from district to district and from township to township. Participate in the average cost of hospitalization of farmers and the average individual at their own expense descending order for the provincial, municipal, district and township hospitals. In 2012-2014, the distribution of new rural cooperative medical funds from high to low were provincial, municipal, district and township hospitals. Conclusion: Under the integration of urban and rural medical insurance, the proportion of in-hospital attendants, hospitalization expenses and hospitalization compensation fees diverted to district-level and township-level hospitals decreased year by year in the Changchun Chaoyang District, and the average inpatient hospitalization compensation rate was the highest in provincial hospitals.