新型农村合作医疗方案调整对参合人住院的影响

目的：研究新农合方案调整对参合人住院费用与频次、受益情况的影响。方法分析2005-2012年广州市番禺地区新农合报销补偿的271113份住院记录，研究不同的个人和政府投入、起付线和报销率的设定、对居民住院费用、基金使用和报销情况的影响。结果较高个人筹资额与补偿比的设定，也伴随了参合人住院费用与频次的上升；较高的区县级、地市级医院起付线，可能会促使参合人在较低起付线的乡镇级医院就医，相关的住院费用较低。结论合理设置新农合筹资水平、起付线及补偿比对新农合合理、平稳运行有重要意义。

Effect of adjustment of new rural cooperative medical scheme on hospi-talization

Objective To study the effect of adjustment of new rural cooperative medical scheme on hospitalization cost and frequency, and benefit level. Methods Claim data on a total of 271 113 new farming compensation records in Pa-nyu district of Guangzhou city were collected, the different funding amount, deductible, compensation rate and their re-lationship with hospital expense and frequency, and benefit level were analyzed. Results Higher funding amount, com-pensation rate were associated with higher hospital expense and frequency; higher deductible of county and prefectural hospital were associated township hospital choice and lower hospital expense. Conclusion The reasonable funding amount, deductible, compensation rate are important for new rural cooperative scheme operation.