河南某县新型农村合作医疗住院补偿情况分析

摘要

Objective: To summarize the flow of inpatients, the hospitalization expenses and the inpatient compensation of New Rural cooperative Medical System (NCMS), and to provide scientific evidence for formulating and improving the compensation policies of NCMS. Methods: Collecting the inpatient compensation data on NCMS of a certain county in Hennan from 2007 to 2009, and analyzing data by SPSS 12.0, Results: From 2007 to 2009, the number of the compensated inpatients, the total hospitalization expenses, the average total hospitalization expenses, the total compensation expenses, the average total compensation expenses and the compensation ratio were constantly increased. There was a tendency that more inpatients and compensation fund had flowed to the county-level and above medical institutions.Conclusion: This county has made a great achievement in the development of NCMS; however, the health resources of the primary medical institutions are in low frequency, and the total hospitalization expenses increase rapidly. Therefore, efforts should be taken to improve the medical services and quality in the primary medical institutions, and to ameliorate the compensation of inpatients. Also, reasonable proposal should be tabled to control the health care expenses.%目的:了解新型农村合作医疗参合农民住院流向、费用及补偿情况,为制定和改善新型农村合作医疗补偿政策提供依据.方法:收集河南某县2007-2009年参合农民住院补偿数据,用SPSS12.0软件进行数据录入处理分析.结果:该县2007-2009年新型农村合作医疗的住院补偿人次、住院总费用、次均费用、补偿总费用、次均补偿费用、补偿比等均不断提高,且病人流向和补偿基金逐年向县级和县级以上级别医疗机构倾斜.结论:该县的新型农村合作医疗取得了良好的效果,但基层医疗机构资源使用率低下,住院总费用增长过快,需重点加强基层医疗卫生机构能力建设,进一步优化新农合住院补偿方案,合理控制医疗费用的增长.