农村互助医疗模式下的居民受益率与利用率

Benefit Rate and Utilization Rate in Rural Mutual Health Care Mode

利用互助医疗项目第3年度镇安县试点机构数据,分析居民受益率和利用率,与实行新型农村合作医疗的镇安县的其他乡镇及国内其他地区相比较。在互助医疗模式下,总的门诊受益率为64.94%,男性受益率低于女性。门诊总的利用率为422.51%,住院总的利用率为2.75%。基金运行良好,达到了预期目标,基金使用率为97.90%。门诊总的补偿比为34.30%,住院总的补偿比为22.90%。互助医疗住院利用率略低于全国新型农村合作医疗平均水平,报销比例偏低。互助医疗模式的实行,降低了居民门诊就诊的费用,引起了需求的释放,门诊受益率和利用率很高,可见门诊需求具有极大的价格弹性。总之,不管实行那种补偿模式,最终目的是缓解"因病致贫,因病返贫",提高卫生服务利用的可及性和公平性,提高农村居民的健康水平。互助医疗模式也不失是一条可供选择的道路。

Benefit rate and Utilizationrate were analyzed based on the 3rd year facility data in Zhen＇an site of rural mutual health care （RMHC） scheme, Comparison was made between the facility data and other towns in Zhen＇an where new cooperative medical scheme （NCMS） was implemented and other districts in China. In the RMHC mode, the total outpatient benefit rate is 64.94%, males＇ is lower than the females＇. The total outpatient utilization rate is 422.51%, the total inpatient utilization rate is 2.75%. The fund operated well and primary goals were accomplished, the fund utilization rate is 97.90%, the total outpatient reimbursement rate is 34.30%, the total inpatient reimbursement rate is 22.90%, the total inpatient utilization rate of RMHC is a little lower than the average level of NCMS, the reimbursement rate is much lower. After the implementation of RMHC, the outpatient fee was reduced, the demand for health service was released, the outpatient utilization rate is much high. the demand for outpatient service has great price elasticity. After all, different schemes with different reimbursement type were all aimed to alleviate the poverty due to illness, to increase the accessibility and fairness towards health service, to increase the health status of rural residents. The RMHC mode is an option to this aim.