怀仁县新型农村合作医疗制度实施现状及纵向比较

THE STATUS AND THE VERTICAL COMPARISON OF NEW COOPERATIVE MEDICAL SYSTEM IN HUAIREN COUNTY

[目的]了解怀仁县新型农村合作医疗制度实施的现状,发现、分析并解决问题。[方法]收集该县2004年和2005年合作医疗及相关卫生事业的数据并进行纵向比较分析。[结果]在前后两个运作周期内,该县在筹资标准不变的情况下,参合率有了显著提高;补偿模式中,不同等级医院起付线间的差距进一步拉大,补偿比例进一步提高;家庭帐户基金的支付比例和实际补偿比维持在较高水平,住院统筹基金支付比例较高,但实际补偿比却较低;参合农民享受住院服务更多的集中于县级及以上医院。[结论]该县应努力健全制度运行的配套设施,扩大筹资规模,正确引导家庭帐户的使用,增加补偿项目,提高补偿比例,同时及早完善乡村基层医疗机构的服务能力。

[Objective] To know the status of new cooperative medical system in Hualren county, find out the problems and solve them. [ Methodsl The data of this county about new cooperative medical system and the correlative medical business in 2004 and 2005 were collected, then a vertical comparison between the two years was made. [ Results] Between the two years, the coverage rate of NCMS in 2005 was significandy higher in the case of a changeless financing standard. The distinctions of the deductible lines were greater among the hospitals of different levels in 2005 in the compensation model, so was the compensation proportion. The payment proportion and the actual compensation proportion of the family accout＇s funds were always great. The payment proportion of the funds of hospital risk pooling was also great, but the actual compensation proportion was low. Besides, the insured got much more hospitalization in county-level hospitals or even above. [Conclusions] The government of Huairen county should try to improve the correlative conditions for operation of new cooperative medical system, enlarge fund raising scale, guide right use of the family accout＇s funds, increase the amount of the compensation items and the compensation proportion, and better the capability of matrical medical services in rural area.