中国卫生政策研究
中國衛生政策研究
중국위생정책연구
Chinese Journal of Health Policy
2015年
10期
29-32
,共4页
马慧芬%朱炜明%张鲁豫%金音子%何莉%岳大海%孟庆跃
馬慧芬%硃煒明%張魯豫%金音子%何莉%嶽大海%孟慶躍
마혜분%주위명%장로예%금음자%하리%악대해%맹경약
医疗联合体%卫生服务整合%患者流向%卫生费用%新型农村合作医疗制度
醫療聯閤體%衛生服務整閤%患者流嚮%衛生費用%新型農村閤作醫療製度
의료연합체%위생복무정합%환자류향%위생비용%신형농촌합작의료제도
Health care alliance%Health service integration%Patient flow%Healthcare expenditure%The New Rural Cooperative Medical Scheme
目的：：对比青海省湟中县实施医疗联合体改革前后新农合住院患者县域内外流向和医疗费用变化情况，分析县域医疗联合体改革对新农合住院患者县内就诊率的影响，并探索影响的原因及途径。方法：利用湟中县2013年与2014年新农合住院患者数据，对患者的就诊流向、住院费用等指标进行分析，并对关键知情者进行访谈。结果：医疗联合体改革后，县外就诊的住院患者人数构成比降低了6．38%，县外就诊的住院总费用环比降低了22．13%，县内、外就诊的次均住院费用分别上涨20．69%、14．41%。结论：县域医疗联合体改革通过提高乡镇卫生院的服务能力，加大县乡村三级医疗机构之间的协同作用，增强了县域卫生体系的整体服务能力，有助于县外常见病和多发病的住院患者回流至县内。
目的：：對比青海省湟中縣實施醫療聯閤體改革前後新農閤住院患者縣域內外流嚮和醫療費用變化情況，分析縣域醫療聯閤體改革對新農閤住院患者縣內就診率的影響，併探索影響的原因及途徑。方法：利用湟中縣2013年與2014年新農閤住院患者數據，對患者的就診流嚮、住院費用等指標進行分析，併對關鍵知情者進行訪談。結果：醫療聯閤體改革後，縣外就診的住院患者人數構成比降低瞭6．38%，縣外就診的住院總費用環比降低瞭22．13%，縣內、外就診的次均住院費用分彆上漲20．69%、14．41%。結論：縣域醫療聯閤體改革通過提高鄉鎮衛生院的服務能力，加大縣鄉村三級醫療機構之間的協同作用，增彊瞭縣域衛生體繫的整體服務能力，有助于縣外常見病和多髮病的住院患者迴流至縣內。
목적：：대비청해성황중현실시의료연합체개혁전후신농합주원환자현역내외류향화의료비용변화정황，분석현역의료연합체개혁대신농합주원환자현내취진솔적영향，병탐색영향적원인급도경。방법：이용황중현2013년여2014년신농합주원환자수거，대환자적취진류향、주원비용등지표진행분석，병대관건지정자진행방담。결과：의료연합체개혁후，현외취진적주원환자인수구성비강저료6．38%，현외취진적주원총비용배비강저료22．13%，현내、외취진적차균주원비용분별상창20．69%、14．41%。결론：현역의료연합체개혁통과제고향진위생원적복무능력，가대현향촌삼급의료궤구지간적협동작용，증강료현역위생체계적정체복무능력，유조우현외상견병화다발병적주원환자회류지현내。
Objective:After examining the changes in medical expenses and flows of hospitalized patients with-in and outside the county under the New Rural Cooperative Medical Scheme ( NRCMS ) before and after the imple-mentation of health care alliance reform, this paper analyzes the impacts of health care alliance reform on the visiting rate of NRCMS patients within the county and explores their causes and channels. Methods:This paper uses the hos-pitalization data of NRCMS patients in 2013 and 2014 collected from Huangzhong county Qinghai province and inter-views with key informants and analyzes the hospitalization expenses, visiting flows and other indicators of patients. Results:After starting health care alliance reform, the total number of hospitalized patients to seek treatment outside the county decreased by 6 . 38%, the total hospitalization expenses to seek treatment outside the county decreased by 22 . 13%, and the hospitalization expenses per inpatient day to seek treatment within and outside the county increased by 14. 41% and 20. 69% respectively. Conclusions: By improving service capabilities of township health centers and increasing synergies between county-township-village health institutions, the county health care alliance reform has suc-cessfully enhanced the service capabilities of health care systems in the whole county and reasonably helped patients with common diseases to be hospitalized outside the county and frequently hospitalized people to return back to the county.
