我国农村合作医疗发展状况的横断历史研究:1994～2017

A Cross-temporal Meta-analysis of Rural Cooperative Medical Development in China: 1994 ～ 2017

有关我国农村合作医疗参合率、参合意愿、满意度等已有大量调查研究成果,然而尚未发现对农村合作医疗制度实施效果变化趋势的相关研究。本文借鉴广泛用于行为科学、心理学领域的横断历史元分析法,对发表于1994~2017年间关于农村合作医疗的247篇文献进行数据提取,考察了农村合作医疗制度实施效果的时间变化趋势及特征。研究发现,农民参合率呈现逐年上升趋势,且东中西部地区差异较小,但参合意愿并未与参合率同步变化,其变化趋势并不明显。农民的总体满意度处于相对稳定的较高水平,不过农民对报销情况、医疗机构服务水平等具体经办情况的分项满意度水平并不高,农村合作医疗制度具体实施过程中的报销流程、报销比例、医疗服务态度、医疗服务水平等有待进一步改善。

There are a large number of research results about the participation rate, the participation willingness, and the degree of satisfaction of rural cooperative medical system in China, but little research about the trend of its implementation effect. This paper used the idea of cross-temporal recta-analysis,which has been widely used in be- havioral science and psychology. We extracted data from 247 articles about the rural cooperative medical care pub- lished during 1994 -2017, and examined the changing trends and characteristics of the implementation effect of the rural cooperative medical care system. The study found that the farmers＇ participation rate increased annually, and the difference among the eastern, central and western regions was small, but the participation willingness was not in sync with the participation rate, and the trend of change was not obvious. Farmers＇ overall satisfaction level with ru- ral cooperative medical service was relatively stable and high, but their satisfaction level with some specific areas such as reimbursement, medical service and so on was not high enough. The reimbursement process, reimbursement ratio, medical service attitude and medical service level of the rural cooperative medical system need to be further improved.