CAJ | 학술논문

目的：从该县的实际情况以及所面临的问题出发，为该县未来新型农村合作医疗政策进行有针对性的调整提供依据。方法：主要利用现场调研的方法收集所需数据，并利用数理统计分析的方法对数据进行描述和分析。结果：2012年该县新型农村合作医疗参合率已达到99.2%，住院人次快速增长，平均住院日基本保持平稳，平均住院费用有明显上涨，参合农民的自付费用逐年增加，自付费用占收入的比例并没有明显下降，各类医疗机构的补偿比例逐年提升，参合农民住院诊断前10位病种3年变化不大，肺部感染居首位。结论：该县新农合基本实现农业人口的全覆盖；仍需调整政策，降低自付费用占人均纯收入的比例；另外，在扩大新农合的病种报销范围的同时，要实施小病分类补偿，优化小病统筹的效率，充分发挥基层医疗机构的优势；多方面着手，以切实提高农民的受益程度，完善新农合政策。
목적：종해현적실제정황이급소면림적문제출발，위해현미래신형농촌합작의료정책진행유침대성적조정제공의거。방법：주요이용현장조연적방법수집소수수거，병이용수리통계분석적방법대수거진행묘술화분석。결과：2012년해현신형농촌합작의료삼합솔이체도99.2%，주원인차쾌속증장，평균주원일기본보지평은，평균주원비용유명현상창，삼합농민적자부비용축년증가，자부비용점수입적비례병몰유명현하강，각류의료궤구적보상비례축년제승，삼합농민주원진단전10위병충3년변화불대，폐부감염거수위。결론：해현신농합기본실현농업인구적전복개；잉수조정정책，강저자부비용점인균순수입적비례；령외，재확대신농합적병충보소범위적동시，요실시소병분류보상，우화소병통주적효솔，충분발휘기층의료궤구적우세；다방면착수，이절실제고농민적수익정도，완선신농합정책。
Objective: According to the actual situation and the faced problems, it provides references for the adjustment of New Rural Cooperative Medical System(NRCMS). Methods: The site survey was used to collect data, the method of statistical analysis was applied to describe and analyze the data. Results: The County’s participation rate of NRCMS had been 99.2% in 2012. The number of inpatients was increasing gradually; the average of stay remained steadily , the average hospitalization cost increased obviously. The out of pocket(OOP) expenditure had increased year by year. The rate of OOP expenditure to net income had no significant decline. The proportion of compensation for various medical institutions had increased. The former ten diseases had never changed in the past 3 years , with pulmonary infection in the first place. Conclusion: The NRCMS had basically achieved full coverage of agricultural population. However it still needs to adjust policies to lower the rate of OOP expenditure to net income. In addition , it needs to implement classification compensation for minor illness, as well as expanding the reimbursement range of the NRCMS, to optimize the efficiency of coordination for minor illnesses, and maximize the use of the advantages of primary health care institutions. In a word, the policymakers need to improve the NRCMS from multi-pronged approaches in order to effectively improve the level of benefit for farmers and implement the policy of NRCMS.