CAJ | 학술논문

目的:探索新农合补偿方案设计的合理思路与方法,为新农合补偿方案的设计与调整以及新农合的健康平稳运行提供科学依据.方法:根据新农合“以收定支,收支平衡”的原则,基于损失分布模型方法,利用陕西某县2010年新农合运行情况以及新农合赔付资料设计补偿方案.结果:按照医疗机构的分级,设计了四种不同的分段费用补偿方案;用TOPISIS评价模型选优排序,确定了方案二为最优方案,补偿效果最好.结论:损失分布模型方法是对新农合补偿方案的测算的一种切实可行的方法,所选补偿方案二能够充分发挥新农合基金的补偿效益.
목적:탐색신농합보상방안설계적합리사로여방법,위신농합보상방안적설계여조정이급신농합적건강평은운행제공과학의거.방법:근거신농합“이수정지,수지평형”적원칙,기우손실분포모형방법,이용협서모현2010년신농합운행정황이급신농합배부자료설계보상방안.결과:안조의료궤구적분급,설계료사충불동적분단비용보상방안;용TOPISIS평개모형선우배서,학정료방안이위최우방안,보상효과최호.결론:손실분포모형방법시대신농합보상방안적측산적일충절실가행적방법,소선보상방안이능구충분발휘신농합기금적보상효익.
Objective: To explore the reasonable compensating design ideas and methods, provide scientific basis for compensating design and adjustment of the new rural cooperative medical system as well as to make it run smoothly. Method: According to the“fixed income support, fiscal balance” principle based on loss distribution model method, using operational statement and compensation data in a rural county of Shaanxi Province 2010 to design compensation plan. Result: 4 segmented compensation plans are designed according to the classification of medical institutions, the evaluation method of TOPISIS is used to rank these plans, which ensures plan 2 had the best effect. Conclusion: The use of loss distribution model method for compensating plan calculation is a practical way, and compensation plan 2 can give full play to new rural cooperative medical fund compensation benefit.