新型农村合作医疗居民个人支付及统筹支付费用的影响因素分析

Analysis of Influencing Factors on the Individual and Pooling Funds Payment of the Inpatient joining New Rural Cooperative Medical Care

目的：分析新型农村合作医疗居民循环系统疾病患者住院费用中个人支付和统筹支付的影响因素，为完善医疗保障体制提供参考依据。方法：选取2011年1月1日～2011年12月31日住院的新型农村合作医疗居民循环系统疾病患者；采用单因素分析和多元回归法分析住院费用的影响因素。结果：新农合患者人均住院费用2140．85元，其中个人支付1093．11元，占51．06％；统筹支付1047．74元，占48．94％。影响两种支付方式的主要因素均有收入水平、入院情况、转归情况、医院感染和医院级别。手术治疗对个人支付费用有显著影响，而住院日对统筹金费用有显著影响（P〈0．05）；结论：在明确诊断的前提下，严格掌握手术适应症，尽量减少住院日，降低住院费用；政府根据病种和患者的病情及治疗方法等因素，制定合理的单病种收费标准，可以有效的降低个人支付和统筹支付费用。

Objective To study the influencing factors on the individual and pooling funds payment of the circulatory system inpatient who joining the medical insurance for rural residents, to provide a reference for medical security system. Methods The hospitalized insured cases joining medical insurance for rural residents were selected in a county from January 1,2011 to December 31,2011. Influencing factors of hospitalized cost were analyzed with univariate analysis and multivariate regression analysis. Results The average hospitalized medical cost for the rural residents was 2140.85yuan, which individual payment was 1093.11 yuan accounting for 51.06%, which the pooling funds payment was 1047.74 yuan accounting for 48.94%. Income levels, hospi- talization status ,outcome of the situation ,hospital infection and hospital level were the main factors affecting the funds payment and the individual payment . Surgical treatment was a significant effect on individuals payment , but hospitalization days was the significant factor affecting pooling funds payment. Conclusion Under the premise of a clear diagnosis ,the surgical indications were commanded strictly to reduce the days of hospitalization, so as to reduce the hospitalized cost. According to the kinds of disease, the patient＇s condition, treatment methods and other factor, the government should establish reasonable fees for single disease, to reduce effectively the individual payments and pooling funds payment.