| 摘要: |
| 目的：分析贵州省新型农村合作医疗运行情况，为进一步完善医保政策、促进城乡居民医疗保险安全运行提供参考。方法：通过新农合管理机构获取贵州省54个县（市、区）2006-2016年新农合运行数据，分别从新农合筹资、支出、结余、费用负担、农民受益等维度，运用SPSS 22.0软件进行统计分析。结果：2006-2016年贵州省样本县新农合参合率和筹资水平逐年递增；各级医疗机构次均住院费用、实际补偿比均呈上升趋势；县外、县本级医疗机构利用率上升，流向县外的基金比例上升明显；基金当年结余波动较大，但后期基本稳定在15%以内。结论：贵州省新农合覆盖面扩大，筹资规模逐年提高，基金支出机制不健全，住院基金监管有待加强，基金总体结余充足，但部分年份基金结余失衡，费用控制的缺乏削弱了农民受益程度。 |
| 关键词: 新型农村合作医疗 医保基金运行 贵州省 |
| DOI： |
| 投稿时间：2018-04-02修订日期：2018-05-09 |
| 基金项目:国家自然科学基金项目（面上项目，重点项目，重大项目） |
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| Analysis of the Operation of New Rural Cooperatives in Guizhou |
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| Abstract: |
| Objective: To analyze the operating status of new rural cooperative medical system(NCMS) in Guizhou, so as to provide references for medical insurance policy making and promoting the safety of medical insurance for urban and rural residents. Methods: Getting 2006-2016 NCMS data of 54 counties (cities, districts) of Guizhou from the NCMS management. Then using SPSS 22.0 software to analyze data from the dimensions of fundraising, expenditure, balance, hospitalization expenses, and farmers' benefit. Results: From 2006 to 2016, the NCMS participation rate and financing level of sample counties in Guizhou increased year by year. The average hospitalization expenses and the actual hospital compensation ratio at all levels of medical institutions increased. The proportion of funds flowing out of the county increased significantly. There are large fluctuations in the balance of the year. In most years the accumulated fund balance rate exceeded 25%. Conclusion: The coverage of NCMS in Guizhou has been expanded. The scale of fundraising has been increased year by year. The mechanism of fund expenditure is imperfect. The use of hospital funds needs to be further regulated. The overall fund balance is sufficient. But there are still some counties had negative balance in the year. And the lack of cost control by NCMS has weakened the farmers' benefit. |
| Key words: new rural cooperative medical system medical insurance fund operation Guizhou |
