“最后一公里”视角下农民异地就医非医疗费用研究

On Farmers' Travel Expense in Non-local Medical Treatment from the “Last Kilometer” Angle

随着农民异地就医直接结算报销制度的全面普及,由此产生的非医疗费用逐渐成为影响农民异地就医选择的关键因素。通过对参合农民异地就医非医疗费用支出的抽样调查可以发现,农民外出到县级及以上医院就医的非医疗费用普遍较高,非医疗费用总额与医院的地域层级有着显著的正相关性,农民患者一次异地就医所产生的平均非医疗费用支出超过低保家庭一个月的低保救助金。因此,探索尝试以最低生活保障线为标准的非医疗费用报销模式,为低保及五保家庭提供一定的交通食宿补贴,可以有效缓解农村低收入家庭的经济负担,破除农民异地就医中的"最后一公里"困境。

As the refunding system does not distinguish local treatment and non-local treatment,non-medical expenditure becomes the key for farmers to choose where to receive treatment.A sampling of the farmers participating new rural cooperative medical care system shows:the non-medical expense is very high when they go to see the doctors in hospitals located in county seats or bigger cities,and the bigger the cities,the higher the expense,and the non-medical expense for a farmer who goes to a hospital in cities exceeds a one-month minimum living allowance for poverty-stricken families.So,it is suggested that the refunding system should take the non-medical expense into account,using the minimum living allowance as the criterion so that the poor families can be economically relieved and the last obstacle in their seeing doctors in cities be removed.