新农合实施前后四种疾病住院费用变化及其成因探讨

目的了解新农合实施后医疗费用和农民医疗负担的变化情况,分析成因并探讨控制医疗费用的对策。方法收集安徽省石台县某医院2006-2009年的单纯性阑尾炎行阑尾切除术、分娩行剖宫产、单纯性小儿疝气手术治疗、脑梗塞无其它并发症等四个单病种住院病人的住院费用资料,比较新农合实施前后医疗费用以及新农合实施后农民实际住院费用的支出情况。结果新农合实行后人均住院费用显著高于实行前,各病种平均住院费用较实施前上涨了6%-15.3%。参合患者实际支出医疗费用较非参合者低,其住院费用报销比例为11.31%-49.93%。结论新农合保障水平较低,医疗费用快速增长是限制新农合保障水平的重要因素,应加强新农合监管力度,提高医疗机构的自我约束能力。

Analysis on Change and Its Causes of Hospitalization Expenses of Four Diseases Before and After Implementing New Type of Rural Cooperative Medical Care System (NCMS)

Objective To investigate the variation of medical expenses and farmers’ medical burden after the implementation of new type of rural cooperative medical care system(NCMS),and to analyze the causes and countermeasures to control medical expenses. Methods The inpatients’ expenditure of those who were only suffering from simple appendicectomy,cesarean section,hernioplasty or cerebral infarction without complication in a hospital of Shitai County from 2006 to 2009 were collected,and the differences of medical expenses and farmers’ medical burden were compared before and after the implementation of NCMS. Results After the implementation of NCMS,the average hospitalization expenses rose significantly than before implementing NCMS,with a rising range of 6%～15.3%.The actual expenditures of patients participated NCMS were significantly lower than those of the non-participants,and the proportion of hospital reimbursement was from 11.31% to 49.93%. Conclusions The security level of NCMS is relatively low.The rapid growth of medical expenses is the important limitation factors.The supervision of NCMS should be strengthened,and the self-restraint capacity of medical institutions also should be enhanced.