新型农村合作医疗制度对医疗机构影响研究

The Impact of the New Rural Cooperative Medical Scheme on Rural Medical Institutions

目的探讨新农合对农村医疗机构的影响,提出医疗机构和新农合制度可持续发展的对策建议。方法收集2003年、2006年镇安县县级医疗机构和乡镇卫生院服务效率和收支情况资料,进行对比分析。结果新农合的开展使医院门急诊的医疗服务量增加;县乡两级医疗机构住院服务量增加,但服务质量有待提高;医院收入增加,医疗收入增长较快;平均每诊疗人次医疗费增加显著。结论完善新农合管理机制;加强对县乡两级医疗机构的建设和监管,提高医疗服务质量;改变支付制度,控制医疗费用增长速度。

Objective： Analyze the impact of NCMS （new cooperative medical scheme ） on rural medical institutions, and give suggestions for the sustainable development of medical institutions and the NCMS. Methods： Collect and analyze the efficiency and the account materials of the county - level heahhcare departments and the town - level health centers of Zhen＇an County in 2003 and 2006. Results ： The implementation of NCMS produced an effect on the increase of the outpatient medical service; the service quality of the county- level medical institutions and the town - level health centers needs to be enhanced in spite of the increase of in - patient medical service; the medical institutions＇income increased, and the medical service fees increased rapidly; the expenditure per person and time rose sharply. Conclusions： Management mechanism of NCMS should be further developed, construction and supervision of the county - level medical sectors and the town - level health centers, especially supervision of the quality of medical sectors be enhanced ; the payment system be changed to control the growth rate of medical expenses.