陕西省神木县“全民免费医疗”医改运行机制评价

目的:了解神木县"全民免费医疗"医改运行机制的情况,为下一步完善神木县医改模式提供依据。方法:通过构建神木县"全民免费医疗"指标体系,对其运行机制进行描述性评价。结果:(1)2009年参保率为95.66%;(2)2009年度基金使用率为66.56%;(3)2009年"全民免费医疗"基金平均补偿比为73.32%;(4)2009年住院人次为24617,比上一年增长107.54%,次均住院费用为5411.87元,比上一年增加30.78%;(5)参保人对"全民免费医疗"的满意率为95.28%。建议:(1)扩宽和稳定筹资来源,确保基金收入稳步增长;(2)建立并完善科学合理的基金分配机制;(3)制定合理的补偿机制,构建医疗费用增长和经办服务水平的监控系统;(4)"全民免费医疗"总体运行绩效良好,但应理性认识该制度的可持续性和可推广性。

Evaluation of operating mechanism of"Free health care for all residents" in Shenmu County Shaanxi Province

Objective：The study is to find out the status of operating mechanism of ＂Free health care for all residents＂ in Shenmu County in order to provide evidence for perfecting the model of medical reform in Shenmu County. Method：To evaluate the operating mechanism of ＂Free health care for all residents＂ in Shenmu County by building the index system. Results：（1） Insurance coverage was 95.66% in 2009; （2） Fund usage was 66.56% in 2009; （3） Fund＇s average compensation ratio was 73.32%; （4） In-patient visits was 24 617 in 2009,which increased 107.54 percent compared to the last year,hospital charges were 5 411.87 yuan,which increased 30.78 percent over the last year; （5） The satisfaction rate among insured people was 95.28%. Recommends：（1） Widen and stable source of fund raising to ensure the steady growth of fund income; （2） Establish and improve scientific and rational fund allocation mechanisms; （3） Make reasonable compensation mechanism,and build the monitoring system to control health care cost and improve health service ability; （4） While the whole system operated well,but it needs rational to know the system＇s sustainability and replicability.