新型农村合作医疗绩效审计研究——以福建省为例

Research on Auditing Performance of Newly-model Rural Cooperative Medical Service:A Case Study from Fujian Province

新型农村合作医疗制度(新农合,NCMS)自2003年试点并逐步推广以来,成效显著。在绩效审计中发现该制度推进过程中面临着筹资水平低、保障程度不高、报销比例设置不合理、农民受益面窄、因病致贫返贫现象依然严重等问题。需要尽快完善新农合的法规体系,强化农民参合意识,创新管理体制,建立稳定的新农合筹资机制,加强新农合监管机制的建设,完善新农合制度的相关配套措施,改革现有的医疗服务体系布局,提高基层诊疗水平,加快新农合的信息化建设步伐,以促进新农合的健康运行和可持续发展。

Being gradually popularized in the way of selected units since 2003,the newly-model rural cooperative medical service system('NCMS' for short) has gained great achievements.With the methods of Government Guidance,farmers voluntary participation,multi-party financing and comprehensive arrangement for serious disease,NCMS has gained a good performance.But during its advance process,it has also been faced with a series of problems,such as low level of funding,low social security,unreasonable reimbursement set,low coverage of benefits and being driven into poverty by medical crises and so on.Summarizing the methods and performance of NCMS and analyzing the problems it has been faced with will play a significant role in realizing the scientific development of NCMS.On the basis of auditing survey of the situation of NCMS from Fujian Province,the development condition and performance of NCMS are analyzed by collecting NCMS forms from different places and database of compensation in hospitals.It is discovered in auditing that there are many challenges in carrying out the system.For the healthy performance and sustainable development of NCMS,it is necessary to further perfect the system designing and study the countermeasure to deal with the problems in the implementation of the system.