本文關鍵詞： 人口老齡化 新型農村合作醫(yī)療 住院基金　出處：《福建醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：人口老齡化對醫(yī)療衛(wèi)生體系的沖擊力度不可小覷，老年人口本身的醫(yī)療需求往往高于其他人群，老年人口的增加往往帶動著醫(yī)療需求的增長�，F(xiàn)有醫(yī)療保障體系能否平穩(wěn)運行、保證基金不出險已成為制度設計者、制度執(zhí)行者和參與者等多方關注的焦點。本研究旨在分析新農合運行情況、老年人住院費用特點，預測5年內老年人口數(shù)量和醫(yī)療服務需求、新農合基金償付壓力，為保障老年人醫(yī)療水平、新農合穩(wěn)定發(fā)展提供客觀依據(jù)。 方法：本研究根據(jù)福州市新型農村合作醫(yī)療管理中心2009—2013年數(shù)據(jù)，運用定量分析與定性分析相結合的方法，使用描述性統(tǒng)計學方法對新農合基金運行情況進行分析，使用人口分要素預測方法、灰色模型預測方法對老年人口、新農合基金發(fā)展情況進行預測。同時，，采用訪談法了解各方對新農合應對老齡化的看法。 結果：（1）福州市新農合運行平穩(wěn)，參合率不斷上升、籌資額穩(wěn)步增長、基金收支基本平衡、補償比例不斷提高、農村居民的受益面和受益程度都得到了提升。（2）福州市新農合系統(tǒng)呈現(xiàn)年老型人口結構，老齡化趨勢明顯，老年人口住院服務利用不斷增長，次均住院費用、人均住院費用不斷升高；老年人口多傾向于非手術治療，藥品費用占比較大；多在鄉(xiāng)級機構就醫(yī)；其住院主要疾病集中在循環(huán)系統(tǒng)、呼吸系統(tǒng)、消化系統(tǒng)。（3）預測結果顯示，未來5年后老年人口數(shù)量將增長至66.76萬人，次均住院費用達12911元，住院基金籌資總額至少應達到17.85億元，人均籌資額至少需536元。 結論：新農合面臨著老年人口增加、住院費用增長、政府籌資負擔加重的挑戰(zhàn)。建議加快醫(yī)保并軌進程，明確補償政策定位，擴大籌資渠道，促進患者分流，健全老年人口保障體系等。
[Abstract]:Objective: the impact of population aging on the health care system is not to be underestimated. The elderly population itself often has higher medical needs than other people. The increase in the elderly population often leads to an increase in the demand for medical care. Whether the existing medical security system can run smoothly and ensure that the fund does not risk has become the designer of the system. The purpose of this study is to analyze the operation of NCMS, the characteristics of hospitalization expenses of the elderly, the number of elderly population and the demand for medical services within 5 years, and the repayment pressure of NRCF. In order to ensure the medical level of the elderly, the stable development of NCMS provides an objective basis. Methods: according to the data of Fuzhou New Rural Cooperative Medical Management Center from 2009 to 2013, using the method of quantitative analysis and qualitative analysis, using descriptive statistical method to analyze the operation of New Rural Cooperative Medical Fund (NCMS). This paper uses the method of population sub-factor forecasting and grey model forecasting to forecast the development of the old population and the New Agricultural Cooperation Fund. At the same time, the author uses the interview method to find out the views of the new rural cooperation on how to cope with the aging. Results: 1) the operation of the new agricultural cooperation in Fuzhou was stable, the participation rate was constantly rising, the amount of funds raised steadily, the fund income and expenditure were basically balanced, and the proportion of compensation was constantly rising. The benefits and the degree of benefits of rural residents were improved. 2) the new rural cooperative system of Fuzhou showed an aging population structure, the trend of aging was obvious, the utilization of hospitalization services of the elderly population was increasing, and the average hospitalization cost. The per capita hospitalization costs are increasing; the elderly population tends to be non-surgical treatment, and the cost of drugs is relatively large; most of them seek medical treatment at the township level; the main inpatient diseases are concentrated in the circulatory system, respiratory system, digestive system, etc.) the predicted results show that, In the next five years, the number of the elderly population will increase to 667,600, the average hospitalization expenses will reach 12911 yuan, the total amount of funds raised by hospital funds should reach at least one billion seven hundred and eighty-five million yuan, and the amount of capital raised per capita should be at least 536 yuan. Conclusion: NCMS is faced with the challenge of increasing the elderly population, increasing hospital expenses and increasing the burden of government financing. It is suggested that the process of medical insurance should be accelerated, the position of compensation policy should be defined, the financing channel should be expanded, and the patient shunt should be promoted. Improve the security system for the elderly population.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：F842.684;F323.89;R197.1;C924.24

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