福建省新型农村合作医疗5年来运行绩效研究

Study on the performance of NCMS for five years in Fujian

目的总结福建省新型农村合作医疗(新农合,NCMS)5年来(2004年7月至2008年12月)的做法与绩效。方法收集各地住院补偿数据库和报表进行统计分析,总结开展的研究和取得的绩效。结果2007年新农合已全省覆盖;5年来平均参合率89.0%;住院补偿260多万人次,受益率4.5%;累计补偿近33亿元;平均基金使用率85.5%;平均实际补偿比31.7%;住院费调整值呈现下降趋势;统一颁发了住院补偿数据库模板,汇总了260多万例数据库;研制了简化基线调查方法、住院补偿方案测算活模板、县级综合评价速算活模板与SPSS程序;举办过10多期培训班。结论福建省新农合5年来开展顺利而稳定,以大病统筹为主的模式切实可行;4项研制系全国首创;全省取得不少经验与良好绩效,缓解了农民的因病致贫返贫,促进了社会和谐与经济建设。

Objectives To summarize the practice and performance of new cooperative medical system （NCMS） in Fujian （2004-2008）. Methods The remedy data of hospitalization cases （HC） and statistical tables were analyzed. The studies and performance were summarized. Results Fujian NCMS totally coverage was in 2007. For recent five years, mean join rate was 89.0%. Getting benefit by HC was of 2 600 thousands, mean rate 4.5%, cumulative remedy fund 3 300 million Yuan, fund expenditure rate 85.5%, actual remedy ratio 31.7%. The adjustment of HC fare shown decreasing tendency. The database template of HC was issued and database of 2.6 million HC was collected. Quick investigation method of basic line, quick calculation template of remedy regulation of HC, quick synthetic evaluation template and SPSS program were designed firstly in China. Conclusion Fujian NCMS model and running is smooth and normal in recent five years. Four studies are designed firstly in China. There are a lot of good performance and studies for lightening poverty by diseases in farmers and the social construction is promoted by NCMS.