新农合“乡镇住院全报销模式”效果评估--基于桑植县的调查数据

Evaluation of “Township hospital full reimbursement mode” in the new rural cooperative medical system: Based on the survey data in Sangzhi county

基于桑植县的调研数据,以该县新农合参合人员报销案例最多的3种典型病例及其代表群体"医疗成本"作为依据,对参合农民乡镇住院全报销的免费医疗模式效果开展评价。在进行改制前后患者"医疗成本"比较,以及患者群体"医疗成本"的比较后发现:改革对农村小儿患者群体住院的医疗费用控制效果较差;对成人患者群体而言,虽报销费用明显增加,但受益被增加的自费开支项目抵消;农村老年患者医疗费用因报销费用提高而受益。

Through the investigation of Sangzhi county in Hunan Province, this paper evaluated the free medical care effects especially township hospital full reimbursement mode in Sangzhi county on the base of 3 typical cases and the medical costs in different groups. After medical costs comparison, we found that the medical reform had poorer result on controlling the medical cost of rural child patient, and the rural adult patient didn＇t benefit much because the rising health care reimbursement was balanced out by the increasing of private expense, while the rural aged patient benefit from the reimbursement increasing in a certain degree.