新医改后农村居民住院流向及费用负担研究

目的:分析新医改后辽宁省农村居民住院流向和费用负担情况。方法:利用2005—2017年辽宁省新农合报表和城乡居民基本医保的相关数据,以及典型地区访谈,收集资料进行分析。结果:新农合使农村居民住院服务需求得到释放,住院流向发生较大变化,流向乡镇卫生院的比例快速下降;同时,参合居民次均住院费用和实际补偿比呈现上升趋势。结论:为保障新农合资金可持续以及缓解农村居民住院费用负担,应采取措施降低居民无效住院率,提高基层医疗机构服务能力,并通过组建紧密型医共体,发挥县域内资源优势,引导农村居民合理选择医疗机构就医。

Study on Hospitalization Distribution and Cost Burden of Rural Residents after New Medical Reform

Objective To analyze the hospitalization distribution and cost burden of rural residents in Liaoning Province after the new medical reform.Method Using the data of the New Rural Cooperative Medical Report from 2005 to 2017 in Liaoning Province and the basic medical insurance for urban and rural residents,then interviews in typical areas and data were collected for analysis.Result The new rural cooperative medical system has released the rural residents'demand for hospitalization services,the hospitalization distribution has changed greatly,and the proportion of the township hospitals has declined rapidly.At the same time,the average hospitalization costs and actual compensation ratio of participating residents have shown an upward trend.Conclusion In order to ensure the sustainability of the NCMS funds and ease the burden of rural residents'hospitalization costs,measures should be taken to reduce the residents'invalid hospitalization rate,and improve the service capacity of primary medical institutions.Through the establishment of a close medical delivery,give full play to the county's resource advantages and let rural residents reasonably choose medical institutions for medical treatment.