新型农村合作医疗制度试点对农民卫生服务利用的影响研究

Impact Research of New Rural Cooperated Medical Scheme on Farmer's Health Care Utilization

目的揭示中国新型农村合作医疗制度试点对农民卫生服务利用的影响效果。方法在控制重要混杂因素的情况下采用分组与空白对照的方法进行分析性研究,通过Propensity Score Match的方法进行两组间的匹配后研究效果指标。结果自愿参合人群有一定选择性;参合对促进门诊利用总量增加有限,但对改善应就诊而未就诊的影响较明显;对促进住院服务利用总量增加明显,由于需住院人数和未住院人数的同时增加,对降低未住院率的作用不明显。不同补偿模式发挥作用不同,以补住院和门诊统筹模式的作用更好。结论试点性的新农合制度对农民卫生服务利用有一定的促进作用,作用的发挥与补偿模式紧密相关,仍需加大筹资力度以更好发挥新农合的作用。

Objective To expose the impact of New rural Cooperated Medical Scheme(NCMS) on farmer s health care utilization.Methods Descriptive method and comparing analysis by controlling confounding factor of health was used with classified group by NCMS,non-NCMS and controlling counties.Propensity Score Match was also used to control confounding and selective bias.Results Population joining NCMS by voluntary was selective.NCMS improved a few outpatient s health care utilization,improved more to those who didn t to v...