湖南省某国家级贫困县新型农村合作医疗制度的实施现状与问题

目的  了解湖南省国家级贫困县—益阳市安化县新型农村合作医疗合作制度的群众知晓率及该项制度实行过程中存在的问题，提出促进新农合制度的进一步完善的建议。方法  以问卷调查的形式对安化县4所新农合定点机构就诊患者进行新农合相关政策的知晓率调查，以访谈形式向安化县新农村合作医疗保险办公室工作人员了解新农合制度实施过程中的成果与存在的问题。结果  群众对新农合制度的知晓水平与年龄和职业相关。新农合制度在实施过程中的问题包括基金运行风险、基本药物不能完全满足常见疾病的治疗、新农合资金的分配比例不够恰当、村级医疗网络的建设不够完善及报销手续繁琐。农民对新农合的改进意见主要集中在简化报销程序、提高报销比例和改善医疗设备上。结论  群众对新农合制度的认知水平有待提高，新农合实施过程中的问题仍需进一步解决和完善。

Implementation status and problems of new rural cooperative medical system in a national-level poverty-stricken county of Hunan province

Objectives To investigate the awareness of new rural cooperative medical system (NRCMS) among resi-dents in Anhua county, a national-level poverty-stricken county in Hunan province, and to reveal problems during the implementation of NRCMS so as to propose suggestions for its improvement. Methods Questionnaire on know-ledge of NRCMS was used to investigate patients who were visiting the doctors in 4 RCMS-designated hospitals in Anhua during the survey. Local NRCMS officials were interviewed about the achievements and problems during NRCMS implementation. Results Residents'' awareness of NRCMS was correlated with age and occupation. The problems during NRCMS implementation were foundation risk, insufficiency of essential drug spectrum, inappropriate allocation of foundation for different diseases, stagnation of rural medical network construction, and tedious procedure of reimbursement. Local residents'' suggestions included simplification of reimbursement procedure, increase of reimbursement proportion and improvement of medical facility. Conclusions Awareness of NRCMS among Anhua residents needs to be improved and problems during NRCMS implementation need to be solved and improved.