访谈2007-2016年新型农牧区合作医疗开展状况——以伊犁州地区为例

Analysis on the development of cooperative medical service in the new agricultural and pastoral areas during 2007-2016 years-a case study of Yili Prefecture

目的了解伊犁州地区新农合经办人员对新农合开展的认识,为今后的医疗保障基金运行提供经验借鉴。方法根据科学的访谈方法,选取各个环节的经办人员,于2017年8月1日-2017年8月20日深入访谈伊犁州5名工作人员。访谈的过程中记录访谈内容,访谈结束后进行分类整理。结果伊犁州地区2007-2016年新农合开展整体效果显著,实现了高覆盖和高参与,农牧民得实惠、医疗得发展、政府得民心的作用,实现了政策目标。存在的主要问题有:医院监管难度大、经办人员不足、乡卫生所缺乏医疗技术人员、缺乏长效监督机制、医院存在新农合应收款问题、农牧民缺乏对新农合政策的深入理解等。结论医疗保障基金监督信息化、科学化,基层医疗保障基金管理规范化、医院医疗保障基金适当预付,基层医疗保障基金加强宣传力度、完善基层新农合经办人员科学配置及晋升机制、提高医疗水平等措施有利于新农合的更好开展。

Objective To understand the awareness of the new rural cooperative medical staff in Yili Prefecture,and to provide experience for the future medical insurance fund operation.Methods According to the scientific interview method,5 staff members were chosen out from each link of the management personnel to interview in-depth during August 1-20th 2017.The content of the interview recorded and sorted by then.Results The overall developing effect of the new rural cooperative medical policy is remarkable,achieving the goal of high coverage and wide participation,benefits for farmers and herdsmen,medical development,and popularity of the government.However,the main problems are:difficulty of hospitals supervision,lack of medical personnel,lack of medical technical personnel in township health centers,lack of long-term supervision mechanism,new rural cooperative fund receivable problems in hospitals,lack of understanding the policy of some farmers and herdsmen.Conclusion The health insurance fund supervision informationization and scientific,basic medical insurance fund management standardization,the hospital medical insurance fund appropriate prepaid,to strengthen the propaganda of basic medical security fund,to improve the grass-roots medical personnel scientific allocation and promotion mechanism,and to improve the level of medical care measures will be conductive to the better development of the new rural cooperative medical system.