Monte Carlo随机模拟在合作医疗补偿方案设计中的应用

导读]通过对新型农村合作医疗制度(新农合)补偿方案进行设计与测评,明确Monte Carlo技术应用于人群仿真的可行性.在人群抽样调查基础上,以Monte Carlo随机模拟构建人群仿真系统,对新农合补偿方案的"保大病"和"保小病"策略进行模拟测评.在住院报销主导策略下,"保大病"方案的总补偿率为0.3782,致贫人数减少率为0.6540,资金结余率为-0.0794;在门诊报销主导策略下,"保小病"方案的总补偿率为0.4840,致贫人数减少率为0.4091,资金结余率为-0.3789.研究结果表明,新农合的补偿原则应以"保大病"为主,同时兼顾"保小病".

Application of Monte Carlo Techniques in designing compensatory scheme of new cooperative medical system

Introduction] To design a workable compensatory scheme of new cooperative medical system (NCMS) in rural China, 'Monte Carlo Simulation Techniques' is developed based on the data of a multistage random sampling survey. The total compensation rate, the decreased percentages of poverty caused by diseases and the deficit ratio of fund a 0.3782, 0.6540 and -0.0794 respectively, when the main strategy of inpatient reimbursement is recognized as 'serious illness'. The deficit ratios of funding appeared to be 0.4840, 0.4091 and -0.3789 when the main strategy of outpatient reimbursement is recognized on minor diseases. Compensation for minor diseases is more important than that of serious diseases. Considering the further impact of minor diseases on peasants, we should incorporate compensation for minor diseases into the compensatory scheme of NCMS.