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为科学测算农村合作医疗筹资额和补偿比,以保持合作医疗系统的正常运转,本研究在综合农村合作医疗和健康保险筹资额与补偿比测算研究方法的基础上,进一步对合作医疗筹资额和补偿比间数量关系模型作了研究;针对目前各地若干种不同补偿范围和项目的合作医疗,利用对山东省农村居民在不同级别医疗机构人均门诊、住院医药费用的调查结果,编制了筹资额和补偿比间数量关系检索表,使人均筹资额的测算和医药费用补偿比的确定更为简明易行、灵活多样、便于操作。该研究方法对在全国范围内恢复和发展农村合作医疗提供了一种科学的技术指导和决策思路。
To scientifically estimate the amount of rural cooperative medical care funding and the compensation ratio so as to maintain the normal operation of the cooperative medical system, this study will further increase the amount of funding for cooperative medical care on the basis of comprehensive rural cooperative medical and health insurance fundraising and compensation ratio measurement research methods. A quantitative relationship model between compensation ratios has been studied; for the current cooperative medical treatment of different compensation scopes and projects in various regions, the fundraising results for the rural residents of Shandong Province using per capita outpatient and inpatient medical costs at different levels of medical institutions have been compiled. The calculation table of the relationship between the compensation ratios makes the calculation of the per capita fundraising amount and the determination of the compensation ratio of the medical expenses more concise, flexible, and easy to operate. This research method provides a scientific technical guidance and decision-making ideas for the restoration and development of rural cooperative medical care throughout the country.