流动人口孕产妇分娩救助探讨

目的:调查流动人口孕产妇分娩限价救助标准及效果评价,探索流动人口贫困孕产妇分娩救助方法。为政府制定措施提供依据。方法:采用回顾性病历分析研究方法,抽取北京市城乡结合部三所试点医院分娩的流动人口孕产妇的分娩资料,选择接受基本服务项目并且住院阴道分娩费用≤1000元的275例产妇为研究组,选择同期孕期检查正常、阴道分娩费用>1000元的312例产妇为对照组。对两组孕产妇分娩费用进行分析。结果:分娩数2004年比2003年平均增加80.3%。研究组总费用平均为909.15元,对照组平均为2102.56元。研究组主要费用花在必须利用的医疗服务上。对照组费用增加主要是药费、床位费、治疗费。由于实施本研究规定的正常分娩基本服务项目及收费,三家医院产科及相关科室收入减少。结论:本项目实施的分娩服务项目及费用对贫困流动人口是可行的,对她们的经济负担影响不大,是可接受的。但救助对试点医院存在显著影响,而且医疗风险增加。所以要实现现行救助方式的可持续性,政府应予以医院补贴及政策支持。

Study on the medicaid for hospital delivery of floating population

Objective:To calculate the costs of medical aid items for hospital delivery of internal immigrant,so as to provide basis for the improvement of medical aid system,and to provide a basis to the government for constituting measure.Methods:Retrospective medical record study was conducted in 3 hospitals of grade B at Beijing suburb to choose 275 lying-in women as intervention group who received the basic medical service,whose gravid examination were normal,and their cost of hospital vaginal delivery≤1 000 yuan;312 lying-in women as comparison group,whose gravid examination in the same time were normal too,and whose cost of hospital vaginal delivery> 1 000 yuan.The two groups of lying-in women's case history and bill in hospital were analyzed.Results:Hospital delivery of internal immigrant in the 3 hospitals was improved by 80.3%.The average cost was 909.15 yuan and 2 102.5 yuan in the intervention group and comparison group,respectively.Intervention group's cost was paid for integrant medical service mostly.Comparison group was paid for medication cost,bed cost and treatment cost.The income of obstetrics department and the related departments decreased for the charging of normal delivery basic service rated by this stuydy.Conclusion:It is feasible to provide basic medical service to normal pregnant woman of internal immigrant,but the medical aid items are low cost services,they should be imbursed by government,so as to establish a medical aid mechanism of sustainable development.