【作者】 杨淞；

【导师】 刘勇；

【作者基本信息】 第三军医大学 ， 军事预防医学， 2010， 硕士

【摘要】 目的通过对西山区新型农村合作医疗运行情况的调查研究,全面了解西山区新型农村合作医疗政策的实施情况,透析参合农村居民、党政干部、合管办工作人员、医疗卫生人员对新型农村合作医疗的真实想法,综合评价新型农村合作医疗制度实施3年来的成功经验和存在问题,有针对性地提出合理化建议,为西山区人民政府和卫生行政主管部门进一步完善新型农村合作医疗制度建设,建立可持续、健康、稳步发展的新型农村合作医疗制度,扩大参合农村居民的受益面,提高受益程度提供科学依据。方法采用流行病学现场研究方法进行研究。通过报表和调查表,收集西山区2007～2009年以来新型农村合作医疗资料(补偿方案、参合情况、资金筹集、门诊费用减免、住院费用补偿等);了解新型农村合作医疗基金使用补偿情况。全部资料采用SPSS统计软件包进行分析。结果新农合基金盘子减小,基金入不敷出从新农合基金筹资与基金补偿情况分析中可以看出,随着农村居民健康意识增强,基金补偿受益率逐年增加,2009年和2008年上半年比较,2009年门诊减免受益率比2008年提高5.5%,住院补偿受益率比2008年提高0.37%。由于城镇发展,用地增加,农转非扩大,大量农业人口转为城镇居民人口,参加城镇基本医疗保险,2009年新农合基金盘子减小,基金入不敷出。建议增加基金盘子,在中央财政2010年每年每人增加补助20元的同时,地方财政也应增加补助20元,使西山区新农合基金筹资达到每年每人170元(中央财政60元+地方财政90元+个人缴纳20元)。结论西山区新型农村合作医疗的运行机制呈良性发展势态,合作医疗的补偿方案基本可行。2009年因农转非,参合人数减少,新农合基金盘子减小,入不敷出。经回归分析,建议2010年增加地方财政补助20元,达到地方财政每年每人补助90元,使西山区新农合筹资每年每人170.00元。综上所述,西山区新型农村合作医疗应继续贯彻“以大病统筹为主,适当兼顾小病”的宗旨,根据本区的实际情况,适度调整新农合补偿方案,提高地方财政补助,提高新农合基金的受益率,把新农合工作由广度向深度建设,使西山区新农合持续、稳步、健康地发展。更多还原

【Abstract】 ObjectiveTo study the current situation of the policy about the new rural cooperative medical system (NRCMS) in Xishan county of Kunming city. To understand the executive of new rural cooperative medical policy in Xishan District. To gain the real idea of NRCMS among rural residents, party and government cadres, and co-management office staff, medical and health personnel. To analyze recent three years’implemented status in order to guide NRCMS practice.MethodsField epidemiology was used in this research. From 2007 to 2009,the NRCMS data was collected from annual report forms and questionnaires that included the documents of implementary planning,the proportion of participants of NRCMS among the population and financing funds. All data were analyzed by using SPSS statistical software package.ResultsReduced fund finance support of NRCMS and the increase of compensation. The analysis of the situation of finance support and compensation showed that with the increased awareness of health among rural residents, the benefit rate of compensation fund increased every year. Out-patient benefit rate and hospital benefit rate of compensation in the first half year of 2009 separately increased 5.5% and 0.37%, compared with that of 2008. Many people participated in urban basic medical insurance thus finance support of NRCMS reduced, because of urban development ,land using increased ,expanding of urban resident changed with rural resident. It caused the lack of finance support and suggested that subsidy of central finance increased 20yuan per year per person in 2010 on the basis of the original, so does the local finance. So the financing funds can reach to 170 yuan per year per person (central finance 60 yuan +local finance 90 yuan + Individuals pay 20) ConclusionsXishan district of the NRCMS run well. The policy of compensation was available. In 2009 due to Farmers turned non-farming, the people to participate has reduced, the number of new rural cooperative funds plate decreases, Deficits,due to the regression analysis,Proposed in 2010 to increase local financial assistance 20 yuan,Local financial assistance to reach 90 yuan per person per year, so that The new rural cooperative fund-raising reach 150 yuan every body every year.In summary, Xishan’s NRCMS should insure the finance for main serious diseases and consider the unserious diseases. The appropriate adjustments of compentative policy of NRCMS is needed. The finance support from local government should be increased to make more benefit for residents. The training of basic health care technique should be hold to improve the service quality. The development of NRCMS need to mobilize different kinds of persons to take part in.更多还原