新型农村合作医疗制度门诊减免方案的调查分析

Investigation of the Cost Reducing or Remitting Scheme for Out-patients in Newly Rural Cooperative Medical System

目的了解新型农村合作医疗(新农合)制度门诊减免方案的评价情况,探讨家庭账户与门诊按比例减免方案的优缺点。方法通过报表收集云南省4个新农合试点县开展新农合以来门诊减免方案、基金筹集、门诊费用减免等资料;以问卷方式调查整群随机抽取的医务人员和参合农民对新农合制度门诊减免方案的意见和建议。结果2003、2004年度,寻甸县、蒙自县、龙陵县门诊减免实施家庭账户制,禄丰县实施门诊按比例减免方案,各县参合农民对新农合制度门诊减免方案满意度评价间差别有显著性意义(P<0·001)。结论各试点县现行新农合制度门诊减免方案基本可行,社会满意度较高,值得借鉴和推广,建议各县积极调整和完善门诊减免方案。

Objective To investigate the conditions of the cost reducing or remitting scheme for out - patients in newly rural cooperative medical system （NCMS） in order to analyze the advantage and disadvantage of establishing family account system and reducing or remitting the cost of out - patients in proportion. Methods In 2005, the data from report forms were collected including cost reducing or remitting scheme, founds raising and reduction or remission of cost for out - patients since practice to now in 4 NCMS trial counties of Yunnan province . Meanwhile, a part of medical staff and participants, who were of people in these counties, were randomly sampled by the cluster sampling to investigate their comments and proposals about the scheme of NCMS through questionnaire method, Results In 2003 and 2004, a family account system was established in reduction or remission of cost for out - patients in Xundian, Mengzi and Longling countries, and a scheme of reducing or remitting the cost of out - patients in proportion was conducted in Lufeng country. There were statistical significant differences （ P 〈 0. 001 ） among every county in participants＇appraisal distributions on the satisfactory degree of the cost reducing or remitting scheme for out - patients in NCMS. Conclusion The current cost reducing or remitting scheme for out - patients in NCMS is basically feasible. The social satisfactory degree was very high. The scheme is worthy of using for references and extending. It was suggested that every county actively adjust and improve the cost reducing or remitting scheme for out - patients.