新型农村合作医疗家庭账户向门诊统筹过渡的实证分析

Empirical Analysis of the Transition from Family Savings Account to Pooling Funds for Outpatient Service of New Rural Cooperative Medical System

目的:分析新农合门诊统筹的实施效果及家庭账户向门诊统筹过渡中存在的问题,为新农合进一步开展提供实证依据。方法:从A县的新农合管理办公室收集2009-2011年新农合运行的相关数据,运用描述性分析及卡方检验,分析和比较不同年度参合率、门诊基金使用率、受益率、补偿比及次均补偿费用的变化情况。结果:与2009年比较,该县在2010年实行门诊统筹后参合率下降;2011年门诊基金使用率提高到83.43%(χ2=37.33,P=0.000),门诊受益率增加至333.89%,门诊补偿比均低于30.00%,次均补偿费用约为10元。结论:总体来说,该县新农合门诊统筹的实施取得了良好的成效,但仍需继续提高门诊补偿水平。

To analyze the effect of implementation of pooling funds for outpatient service of New Rural cooperative Medical Sys- tem （NRCM） and the problems in transition from family savings account to pooling funds for outpatient service ,to provide an empirical basis for the adjustment of NRCM. Methods ： Collecting data about the NRCM operating status from NRCM management office in A county in 2009 - 2011, and analyzing and comparing the difference in participation rate, utilization rate, benefit rate, outpatient reimbursement rate, average compensation with descriptive analysis and Chi - squre Test. Results：After the implementation of pooling funds for outpatient service in 2010, there was a de- crease in participation rate compared to 2009. In 2011, the utilization rate of outpatient fund raised to 83.43 % （X~ = 37.33, P = 0. 000）, while the benefit rate increased to 333.89%. Otherwise, the outpatient reimbursement rate was less than 30.00% while the average compensation was about 10yuan. Conclusion： As a whole, The county had made a great achievement in pooling funds for outpatient service of NRCM. However, it still need to raise the outpatient service compensation level.