长治市某县常见慢性病新农合服务利用情况的调查

Survey on Service Utilization of the New Rural Cooperative Medical Scheme for Several Common Chronic Diseases in a County of Changzhi city

目的:了解几类常见慢性病参合农民住院服务的利用情况,分析常见慢性病的住院负担和新农合的补偿现状,为完善新农合制度的补偿方案提出理论依据。方法:将长治市襄垣县2010—2013年参加新农合农民中住院病人报销的原始资料统一汇总。采用SPSS18.0软件,对几种参加慢性病不同年份、不同医院级别及不同病种的住院人次、住院费用、补偿比例、负担比例和药费比等指标进行描述性分析,并进行组间的Z2检验、χ2检验等。结果:常见几类慢性病中,除呼吸系统疾病住院人次增加比(-7.91%)有所下降外,心血管疾病、脑血管疾病和恶性肿瘤住院人次增加比分别为42.80%、15.80%和2.37%;恶性肿瘤、脑血管疾病、心血管疾病和呼吸系统疾病次均住院费用分别为10 462.56、6 864.67、6 715.15、4 684.96元,药费比分别是52.62%、50.59%、63.32%和38.41%;省级及以上医院次均住院药费最高14 559.70元,乡镇医院住院最低1 096.09元;省级及以上医院药费比(78.89%)最高,市级医院(33.21%)最低,乡镇医院(42.50%)居于第二位。结论:常见慢性病是参合农民的重要疾病负担,新农合针对慢性病的报销范围和力度应该进一步加强。

Objective：To learn the utilization of the new rural cooperative medical scheme（NRCMS）for several common chronic diseases,to analyze the hospitalization burden of patients with common chronic diseases as well as the indemnity situation of this scheme and to put forward the theoretical basis to improve the indemnity program of NRCMS.Methods：The original data of the new rural cooperative medical reimbursement from 2010 to 2013was collected in Xiangyuan county,Changzhi city.Descriptive analysis was performed for indicators of insured patients with different chronic diseases from different years and hospital hierarchies by using SPSS18.0software,including the number of inpatients,hospitalization expenses,the compensation rate,self-support rate,and rate of expenses for medicine.Z2 and tests were performed to make comparisons between groups.Results：Among the common chronic diseases,the increased proportion of the number of inpatients with respiratory diseases was decreased（-7.91%）,while the increased proportion of the number of patients with cardiovascular diseases,cerebrovascular diseases,and tumors was 42.80%,15.80%and 2.37%,respectively.For patients with malignant tumors,cerebrovascular diseases,cardiovascular diseases,and respiratory diseases,the average cost for each hospitalization was 10 462.56 yuan,6 864.67 yuan,6 715.15 yuan and 4 684.96 yuan,respectively,while the rate of expenses for medicine was 52.62%,50.59%,63.32%,and 38.41%.The expenses for medicine during hospitalization were the highest in provincial or superior hospitals（14 559.70yuan）and the lowest in county-level hospitals（1 096.09yuan）.The rate of expenses for medicine was the highest in provincial or superior hospitals（78.89%）,followed by county hospitals（42.5%）,while the lowest in municipal hospitals（33.21%）.Conclusion：Common chronic diseases are the main disease burden for farmers who participate in the NRCMS.Therefore,the scope and potency of reimbursement for chronic diseases in the NRCMS should be widened and strengthened.