蓝山、桑植两县新型农村合作医疗限额付费方式调查

Investigation on Limiting Payment under New Rural Cooperative Medical System in Lanshan

目的:总结蓝山和桑植两县新农合支付方式改革的新经验、新方法,为进一步深化改革提供经验和理论支持。方法:运用普查和抽样调查方法,对两县推行新农合支付方式改革的总体情况进行调查,并对部分乡镇卫生院及其医务人员、患者进行问卷调查和深入访谈。结果:两县推行限额付费方式,当年新农合基金风险可控,医、患满意度高。结论:明确医疗服务的享受主体、服务主体及范围,科学制定总额预付标准,完善改革以有效规避医患道德风险,建立医疗服务与社会医疗保险二位一体的新体制等。

Objective： Summarize new experience and method of new rural cooperative medical system payment refi^rm＇s experience and theoretical support in Lanshan and Sangzhi. Methods： Using census and sample survey methods, the overall situation of implementing new rural cooperative medical system in these two counties was investigated, and part of the township and medical staff members we~ investigated by questionnaires and in-depth interviews. Results： Two counties introduced limiting payment, the new rural cooperative medical fired risk control, physician, and patients have high satisfaction. Conclusion： Clearly settle the body, subject and scope of medical service, make the total prepaid standard, impn）ve reforms to effectively avoid the moral risk, medical services and social medical insurance.