南京市新型农村合作医疗建立统一住院费用补偿方案探讨

目的 探索南京市新型农村合作医疗建立统一住院费用补偿方案的可能性.方法 抽样调查了南京市"四区一县"2005年参合农民的住院费用资料,用"分级、分段、累加补偿"的方法设计参合农民的住院费用补偿比.结果 全市新型农村合作医疗建立完全统一的住院补偿标准是有困难的,可以建立相对统一的住院费用补偿方案:实行"0"起报;在费用段相同的情况下,各区县的补偿比根据实际情况测定,在20%70%间适当选择;可以制定统一的封顶线和补偿范围.结论 全市若要实现补偿标准完全统一的目标,应分步骤、有计划地实施,通过政府财政筹资,不断调整各区县的筹资差异,逐步减少补偿方案的差别.

On the uniform reimbursement plan for hospitalization expenses under the new rural cooperative medical system (NRCMS) in Nanjing city

Objective To probe into the feasibility of establishing a uniform reimbursement plan for hospitalization expenses under NRCMS in Nanjing city. Methods Hospitalization expenses in 2005 for peasants under NRCMS from the sour suburb districts and county in Nanjing were sampled. Based on this study, a reimbursement ratio was designed for such peasants as classified by "grades, sections and accumulated reimbursement". Results A uniform NVRMS reimbursement plan for hospitalization expenses may not be practical for all peasants in Nanjing. Yet such a plan of relative uniformity is worthy of experimenting as follows: no minimum for reimbursement;within the same expense range, reimbursement ratio may be measured and fixed accordingly among districts and county in the city, ranging 20%-70%;a uniform ceiling and reimbursement range are recommended. Conclusions A uniform city-wide plan requires by-step and planned implementations. With support from government finance, fund-raising gaps among these areas can be narrowed gradually, cutting back differences in their reimbursement plans in the end.