武汉市江夏区新农合住院费用支付方式改革效果分析

Evaluation on Payment Reform of New Rural Cooperative Medical Scheme in Jiangxia District of Wuhan City

目的评价江夏区新农合支付方式改革的效果。方法通过新农合管理办公室收集江夏区新农合基金运行情况以及试点医院住院费用、住院人次、住院补偿金额和比例等数据。结果支付方式改革后,试点医院住院费用增长速度变慢,2011年增长率为2.48%;补偿比例增长速度变快,2011年增长率为11.13%;住院基金结余率从上年的0.37%增加到4.42%。病人流向稳定,医疗机构初步形成自我约束机制。结论支付方式改革后,医疗费用的不合理增长得到控制,新农合住院基金更安全,参合农民利益得到了保障。但还应探索更合理的付费标准制定方法。

Objectives To evaluate the effects of payment reform in Jiangxia district. Methods Collect the data a- bout the New Rural Cooperative Medical Scheme （NRCMS） fund operating, and the medical costs, hospitalization days, the amount and proportion of compensation. Results After the reform, the growth rate of medical costs de- ceased （2. 48% in 2011）, the growth rate of compensation ratio increased （11.13~ in 2011）, and the balance rate of hospitalization fund increased from 0.37% to 4. 42%. The trend of the patient flow was stable. The hospitals formed the mechanism of self-restraint. Conclusions After the reform, unreasonable growth of medical costs is con- trolled, the hospitalization fund come to be safer, the interests of the patients are protected. And more reasonable standard of payment should be explored.