三种新农合经办模式下支付方式改革对医疗费用控制效果评价研究

Effects of payment reform on healthcare costs control among three host modes of new rural cooperative medical system

目的:评价三种新型农村合作医疗经办模式下新农合支付方式改革对医疗费用控制效果,为进一步推进新农合支付方式改革提供依据。方法:采用文献分析法和专家小组讨论法确定支付方式控制医疗费用的评价指标,在此基础上运用秩和比法和TOPSIS法进行评价。结果:三种经办模式下,对门诊和住院医疗费用控费效果最优的支付方式存在一定的差异性。结论:医疗费用控费效果最优的支付方式充分考虑到了其经办模式所涉及的主要利益相关者及其战略利益诉求,进而才能实现控制新农合医疗费用不合理增长的目的。

Objective To evaluate the effects of payment reform on healthcare costs control among three host modes of new rural cooperative medical system（NRCMS）.Methods The Document analysis and the expert panel discussion method were used to determine the evaluation indicators.On this basis,the RSR and TOPSIS methods were used for evaluation.Results Among three host modes,there were some differences in the payments which could optimally control the outpatient and inpatient healthcare costs.Conclusions Main stakeholders and their strategic interests should be taken full consideration so as to achieve the control of unreasonable growth in NRCMS healthcare costs.