新疆新农合补偿模式研究及补偿水平预测

An Analysis and Prediction of the Compensation Model of New Rural Cooperative Medical System in Xinjiang

实现新农合制度的可持续发展,科学合理的补偿制度是关键。新疆地区开展了"门诊统筹+住院统筹+大病统筹"的补偿模式,在门诊和住院补偿的基础上,设立新农合大病统筹基金,开展大病统筹工作。本文在结合新疆现有的新农合补偿机制的基础上,搜集2008-2013年新疆新农合发展的有关数据,选取影响新农合补偿发展的相关指标,通过主成分分析和二次指数平滑等方法对未来几年新疆新农合的补偿水平进行预测。预测结果显示,在未来几年新疆新农合的补偿水平将持续上升,但基金缺口现象也将随之逐渐扩大。在此基础上本文提出了新疆新农合补偿机制的优化思路。

The scientific and reasonable compensation system is the key factor in realizing the sustainable development of New Rural Cooperative Medical System. The mode of ＂outpatient, hospitalization and subsidy for serious diseases＂ is carried out in Xinjiang, which sets up a pooling fund for serious diseases in addition to the outpatient and hospitalization compensation. Based on the compensation mechanism of the New Rural Cooperative Medical System, this paper collects the related data in the period from 2008 to 2013. And then, this paper prediets the development tendency of New Rural Cooperative Medical System in Xinjiang through the method of PCA （ Principal Component Analysis） and Exponential Smoothing. From the analysis, we can see that the compensation of the New Rural Cooperative Medical System in Xinjiang will keep rapid growth in the following years. On the one hand, this phenomenon explains that the New Rural Cooperative Medical System＇ compensation in Xinjiang has a good trend of growth. On the other hand, as the increment speed of finan- cing of the New Rural Cooperative Medical System cannot catch up with the compensation, it will lead to the financial deficit which al- ready happened in 2013. At last, the paper provides some suggestions based on the above analysis.