江苏省新型农村合作医疗定点医疗机构信用等级评定研究

Analyzing Credit Level Appraisal on Designated Medical Instituions under New Rural Cooperative Medical System in Jiangsu

目的:通过对新型农村合作医疗(新农合)定点医疗机构信用等级的评定,为规范新农合定点医疗机构管理提供有效方案。方法:采用第三方评价法,对江苏省27家新农合定点医疗机构进行信用等级评定,根据被评定机构相关属性分组并将评定指标进行统计学比较分析。结果:2012年较2011年定点医疗机构高信用等级有所增加;公立医疗机构、有住院部的医疗机构及综合医院信用等级相对更高,相关指标差异显著,P≤0.05。结论:信用等级偏低医疗机构存在收费混乱、医疗费用增长过快现象,医疗服务管理尚有欠缺,需要进一步完善新农合管理制度,探索更为有效的新农合支付方式,加强对民营医疗机构的监管,加强人才引进与培养,改进评定标准与方式,促进新农合制度可持续发展。

Objective： Through evaluating the ereadit level appraisal of designated medical institutions under new rural cooperative medical system （NCMS） , effective method of standard management for NCMS designated medical institutions under was proposed. Methods： Use third-party evaluation to evaluate the 27 NCMS designed medical institutions in Jiangsu, divide the results into groups and make a comparative analysis based on the relevant properties of rated agencies. Results： Compared to 2011. the credit level appraisal on NCMS medical institutions in Jiangsu is higher in 2012; the score of public medical institutions, medical institutions with inpatient department and the general hospitals are higher. The relevant indexes of correlation have significant difference. P≤0.05. Conclusion： Some low-credit medical institutions have disordered charge and over-increasing medical cost. The medical service management needs to be completed. It needs to further implement the management system of NCMS, discover more efficient payment of NCMS, enhance the supervision on private medical institutions, improve the introduction and training of talents and promote the standard and method of evaluation, so as to improve the sustainable development of NCMS.