西部某县城乡居民合作医疗运行情况分析

Operation of Urban-Rural Residents Cooperative Medical Scheme in a District in West China

目的:通过分析西部某县城乡居民合作医疗运行情况,发现运行过程中出现的问题,提出解决问题的建议。方法:对2008年和2009年该县城乡居民合作医疗运行数据做对比分析。结果:该县在城乡居民合作医疗运行过程中出现了住院人次、住院率和住院费用增长过快,参合居民受益水平增长不明显,城镇居民占用农村居民卫生服务资源的问题。结论:建议该县实施支付方式改革,适当调整补偿方案,完成合管办从卫生部门到人力资源与社会保障部门的平稳过渡。

Objective： To find out problems and propose countermeasures by analyzing the state of Cooperative Medical Scheme （CMS） in a west county in China. Methods： Comparing the data of CMS in 2008 and 2009. Result： The hospitalization, hospitalization rate, and hospital cost increase too fast during the running of the CMS in this county; the growth of benefit level of the participating residents is not obvious; and urban residents impropriate the health service resources of rural residents. Conclusion： The county should do some payment reform and adjust the compensation programs to make a smooth transition of CMS Management Office from the health department to human resources and social security departments.