新型农村合作医疗运行状况及住院补偿比影响因素分析

Analysis of implementation and influencing factors of hospitalization reimbursement rate on New Rural Cooperative Medical Scheme

目的:了解新农合运行状况及影响住院补偿比的因素。方法:利用系统抽样方法在4地对1034名参合农民进行问卷调查,运用路径分析模型和多元回归分析方法探讨影响住院补偿比的因素。结果:受访者新农合实际住院补偿比例为20.58%;新农合补偿后住院费用构成灾难性支出的比例减少了7.5%,贫困率降低5.49%;受访者对住院补偿制度的知晓率为31.81%,满意率为98.75%;23.5%的受访者愿意缴纳20元以上的个人参合费。参合者就诊医院级别与住院补偿比的标准回归系数最大,参合者就诊医院级别可以对住院天数、住院费用、住院补偿金额和住院补偿比例产生影响。结论:新农合能够在一定程度上减轻农民疾病负担,但住院补偿比例偏低,参合者对新农合的满意度较高,但对合作医疗制度的知晓率较低;参合者就诊医院级别是影响住院费用和住院补偿比例的主要因素。

Objective：Analyzing implementation and influncing factors of hospitalization reimbursement rate on New Rural Cooperative Medical Scheme（NRCMS）. Method：Surveying 1 034 enrollees in 4 sampled counties through systematic sampling. Through path analysis to explore influencing factors of hospitalization reimbursement rate. Results：Enrollees＇ effective hospitalization reimbursement rate on NRCMS was 20.58%. After reimbursement of NRCMS,family rate of catastrophic health expenditure reduced 7.5% and poverty rate decreased 5.49%. Knowledging rate of enrollees on NRCMS was 31.18% and satisfaction rate was 98.75%. 23.5% of enrollees were willing to pay above 20 yuan RMB premiums. Standardized Coefficient of hospital level with hospitalization reimbursement rate of NRCMS was highest in the model of hospitalization reimbursement rate of NRCMS. And hospital level could influence length of stay,hospitalization expenses and hospitalization reimbursement amount. Conclusion：NRCMS could more or less reduce enrollees＇ burden of disease,but hospitalization reimbursement rate of NRCMS was relatively low. Enrollees had higher satisfaction for NRCMS but their knowledge rate was low. Hospital level was key influencing factor of hospitalization expenses and hospitalization reimbursement rate of NRCMS.