我国农村医疗保障制度住院补偿效果分析

Analysis of Inpatient Compensation Effect of Rural Medical Security System in China

目的:分析我国农村现行医疗保障制度住院补偿的效果,对其中医保制度设计存在的问题进行探讨。方法:通过入户调查收集农村居民的相关信息,分别对不同医保形式、不同住院流向农村居民的住院补偿情况进行分析。结果:不同医保覆盖农村居民的住院率间具有显著差异(2=16.231,<0.05);不同医保制度的住院补偿比例具有显著差异(2=33.173,<0.05);不同住院流向参合居民的补偿比例随着住院层次的提升而显著降低(2=58.527,<0.05)。讨论:现行农村医保制度设计在有效发挥作用,并在一定程度上抑制居民合理的卫生服务需求。同时,不同医保制度的补偿比例在参保人群中具有一定的"利富"效应。

Objective： To analyze inpatient compensation effects of current rural medical security system and explore the existing system design problems. Methods： The relevant information about rural residents was collected through household survey, and the inpatient compen- sation among rural residents covered by different medical insurances and flowing to different levels of medical institutions was analyzed re- spectively. Results： There were significant differences among hospitalization rates of rural residents covered by different medical insurances ~2~I6.231, P〈0.05） and inpatient compensation ratios of different medical insurances （Z2=33.173, P〈0.05）; the compensation ratio among re- sidents covered by NCMS would significantly reduced along with the level of hospitalization raised （Z2~58.527, P〈0.05）. Discussion： At the same time of working effectively, current rural medical insurance system could restrain the reasonable health service demand at some degree because of designing. And the compensation ratios among different medical insurances had some ＂pro-rich＂ effect in covered residents.