新农合对农民医疗费用影响的五年连续追踪研究

A five-year follow-up survey on the effect of the new rural cooperative medical system on the village residents' medical expenses

目的:通过5年追踪调查,了解新农合的实施对农民医疗费用的影响及其变化趋势,为新农合的管理与决策提供科学依据。方法:采用多阶段分层整群随机抽样法抽取婺源县3个乡镇9个行政村,每村调查约70户,进行入户调查,每年调查1次,将连续5年调查结果进行纵向对比研究。结果:本次调查农民年人均医疗费用为340.79元,其中门诊费用为164.14元,住院费用为176.65元,总体上均呈上升趋势,平均增长速度分别为10.72%和14.32%,次均住院费用比2005年和2006年调查结果要低,主要表现为县以上医疗机构次均住院费用降低;乡卫生院次均住院费用呈上升趋势。结论:新农合实施以来,婺源县农民医疗费用上升较快,但由于采取了控制措施,费用增长得到初步控制;但乡卫生院的次均住院费用仍在增长,应加强医疗费用控制。

Objective To understand the effect of the new rural Cooperative Medical System （CMS） on farmers＇ medical expenses and its changing trend through a 5-year follow-up survey and to provide a scientific basis for management and decision--making of the new rural CMS. Methods A survey was carried out by interviewing farmers in their homes. The multi-phase stratified cluster random sampling has been adopted to select 9 administrative villages from 3 townships with 70 families from each village. The investigation has been implemented once a year for five years in succession. A lengthwise contrast has been done based on the findings. Results According to the survey findings, the annual medical expenses per capita is 340. 79 yuan. The annual outpatient clinical expenses per capita is and the annual hospitalization expenses per capita is 164. 14 yuan and 176.65 yuan, respectively. On the whole, there is a rising trend and the average velocity of increase reaches to 10. 72% and 14. 32% respectively. The average hospitalization expenses per time is lower than that of 2005 and 2006 ,which mainly results from the decrease of the average expenses in hospitals above county-level medical institutions. The average hospitalization expenses per time in township health centers increased significantly, Conclusion Farmers＇ medical expenses in Wuyuan county has increased quickly after the implementation of the new rural CMS. Yet the cost growth has been controlled with many available measures. The expenses in township health centers still increased, so it is necessary to strengthen the control of expenses.