CAJ | 학술논문

目的：本研究从需方角度分析新型农村合作医疗按人头支付改革实施的效果，为进一步完善“按人头支付”改革提供依据。方法：采用描述性分析比较2011年和2012年按人头支付改革前后参合农民受益面、受益程度、医疗费用负担及抗风险能力等指标；采用问卷调查研究浦东新区33家社区卫生服务中心参合农民改革前后的满意度情况。结果：新型农村合作医疗按人头支付改革后，参合农民受益率和住院受益程度在一定程度得到提高，参合农民费用负担及其抗疾病风险的能力得到一定程度的改善和提高，同时按人头支付改革的推进并降低参合农民的满意度。结论：按人头支付改革在一定程度上降低了参合农民的就医经济风险，改革的长期效果有待继续研究深入。
목적：본연구종수방각도분석신형농촌합작의료안인두지부개혁실시적효과，위진일보완선“안인두지부”개혁제공의거。방법：채용묘술성분석비교2011년화2012년안인두지부개혁전후삼합농민수익면、수익정도、의료비용부담급항풍험능력등지표；채용문권조사연구포동신구33가사구위생복무중심삼합농민개혁전후적만의도정황。결과：신형농촌합작의료안인두지부개혁후，삼합농민수익솔화주원수익정도재일정정도득도제고，삼합농민비용부담급기항질병풍험적능력득도일정정도적개선화제고，동시안인두지부개혁적추진병강저삼합농민적만의도。결론：안인두지부개혁재일정정도상강저료삼합농민적취의경제풍험，개혁적장기효과유대계속연구심입。
Objective: It aims to evaluate effectiveness of capitation reform in NRCMS in Pudong New Area from demanders ’ perspective, and to provide more basis for implementing the reform. Methods: By collecting indicators’ related data of the benefit coverage, health service utilization, reimbursement degree, expense burden and resistance capabilities of participant in pilot areas, and doing statistical analysis; a questionnaire was designed to investigate the satisfaction of patients in 33 community health service centers and the survey was conducted twice in the same month in 2011 and 2012 for comparison. Results: After the implementation of the capitation, the benefit ratio and hospitalization benefit levels were improved, and the outpatient service utilization was guaranteed. The resistance capabilities were enhanced. Meanwhile measures to promote the capitation reform did not affect the satisfaction of participant. Conclusion: The capitation reform reduce the medical economic risk of participating farmers, the long-term effect of the reform still needs further study.