苏州市社会医疗保险在社区卫生服务中的影响分析

Impact of Social Medical Insurance on Community Health Service in Suzhou

目的:了解苏州市社区卫生服务机构的业务收入与社会医疗保险情况及两者之间的关系。方法:对苏州市三个老城区所属的37家社区卫生服务机构的业务收入进行问卷调查及定性访谈。结果:在2006年度苏州市社区卫生服务的业务收入中,基本医疗收入所占的比重最大,在90%左右。而在基本医疗收入中,比例最高的依旧是药品收入,占业务总收入的80%左右。社会医疗保险对社区卫生服务机构的覆盖率是91.7%,对其业务收入的补偿在60%左右。苏州市三个老城区在社区卫生服务业务总收入和社会医疗保险的补偿方面均无统计学差异。结论:药品收入是社区卫生服务业务总收入的主要来源,社会医疗保险在社区卫生服务机构中的覆盖面较广、补偿程度较高。

Objectives To learn about the business income of conmmnity health service institutions and the situation of social medical insurance and their relationship in Suzhou. Methods We investigated the business income of 37 community health service institutions with the questionnaire and qualitative interview in three old districts in Suzhou. Resuhs Among the business income of community health service institutions in 2006, the income from basic medical care was highest, which accounted for about 90%. Among the income from basic medical care, the income from medicine was still highest, which accounted for about 80% of total income. The coverage rate of social medical insurance to community health service institutions was 91,7% and its reimbursement ratio to community health service institutions was about 60%. There were not statistical differences for the business income and the reimbursement from social medical insurance among the three old districts. Conclusions Medicine income is the main source of business income for community health service institutions. The coverage of social medical insurance to community health service institutions is broad and its reimbursement is high.