新型农村合作医疗住院补偿方案设计:以陕西省某县为例

In-patient Compensation Scheme Design of the New Rural Cooperative Medical System: Taking a County in Shaanxi Province as an Example

目的:探索新农合补偿方案设计的合理思路与方法,为新农合补偿方案的设计与调整以及新农合的健康平稳运行提供科学依据。方法:根据新农合"以收定支,收支平衡"的原则,基于损失分布模型方法,利用陕西某县2010年新农合运行情况以及新农合赔付资料设计补偿方案。结果:按照医疗机构的分级,设计了四种不同的分段费用补偿方案;用TOPISIS评价模型选优排序,确定了方案二为最优方案,补偿效果最好。结论:损失分布模型方法是对新农合补偿方案的测算的一种切实可行的方法,所选补偿方案二能够充分发挥新农合基金的补偿效益。

Objective： To explore the reasonable compensating design ideas and methods, provide scientific basis for compensating design and adjustment Of tile new rural cooperative medical system as well as to make it run smoothly. Method： According to the ＂fixed income support, fiscal balance＂ principle based on loss distribution model method, using operational statement and compensation data in a rural county of Shaanxi Province 2010 to design compensation plan. Result： 4 segmented compensation plans are designed according to the classification of medical institutions, the evaluation method of TOPISIS is used to rank these plans, which ensures plan 2 had the best effect. Conclusion： The use of loss distribution model method for compensating plan calculation is a practical way, and compensation plan 2 can give full play to new nlral cooperative medical fired compensation benefit.