新型农村合作医疗门诊补偿方案对居民就诊机构选择影响研究

目的:调查农村居民门诊就诊机构现状,分析新型农村合作医疗门诊统筹补偿方案对其影响,为完善方案设计提供参考依据。方法:采用定量与定性相结合的研究方法;通过问卷调查法,对6 024位农村居民进行了入户调查;通过文献法,收集相关政策文件,了解被调查地区门诊补偿方案设计现状。结果:被调查地区门诊补偿均为门诊统筹模式,具体补偿方案不尽相同;被调查居民门诊就诊机构以村级和乡镇级医疗机构为主,主要原因为距离近和新型农村合作医疗能给予补偿;基层医疗机构门诊补偿比例是农村居民选择门诊就诊机构影响因素之一。结论:被调查地区农村居民门诊主要选择在基层医疗机构就诊,新型农村合作医疗补偿比例是其选择机构的一个重要影响因素。因此,应逐步提高新型农村合作医疗门诊补偿水平,并对基层医疗机构设置较高补偿比例。

Research on influence of the New Rural Cooperative Medical Scheme out-patient reimbursement plan on choosing different level Medical institutions

Objective:To explore influence of New Rural Cooperative Medical Scheme(NCMs)out-patient reimbursement plan on rural residents choosing different level medical institutions,for providing a reference basis to perfect out-patient reimbursement plan of NCMs.Methods:Both quantitative research and qualitative research were used.Using the questionnaire survey menthod,6 024 rural residents were surveied.Using literature method,relevant policies and documents were gathered.Results:Out-patient fee were all reimbursed by pooled funds in three areas,but specific reimbursement plan were different in different areas.Rural residents in three areas choosed village clinics and township hospitals mostly when they need out-patient service,mainly due to nearby and could be reimbursed by the NCMs.Outpatient reimbursement rate of primary medical instutions was one of factors which influenced rural residents choosing medical instutions.Conclusion:Rural residents in three areas choosed primary medical instutions mostly when they need out-patient service,outpatient reimbursement rate was an important influence factor.Therefore,the outpatient reimbursement level should rise gradually,and reimbursement rate in primary medical instutions should be higher than that in high level medical instutions.