發(fā)布時間：2018-03-21 04:49

  本文選題：新型農(nóng)村合作醫(yī)療　切入點：患者滿意度　出處：《中南大學》2013年碩士論文　論文類型：學位論文

【摘要】：目的：通過對湖南省桑植縣新型農(nóng)村合作醫(yī)療的現(xiàn)狀分析、綜合評價桑植縣新農(nóng)合補償模式改革的效果,發(fā)現(xiàn)其在運行過程中存在的問題和不足,為下一步桑植縣新農(nóng)合補償模式的改革和完善提供依據(jù)和建議。 方法：根據(jù)研究目的,從湖南省桑植縣“新農(nóng)合信息數(shù)據(jù)庫”中調(diào)取有關數(shù)據(jù)轉換成Excel,然后進行數(shù)據(jù)的校對和數(shù)據(jù)的整理分析。 桑植縣新農(nóng)合補償模式改革患者滿意度調(diào)查采用分層整群隨機抽樣方法,根據(jù)當?shù)亟?jīng)濟發(fā)展水平和農(nóng)村居民年人均純收入將桑植縣縣的39個鄉(xiāng)鎮(zhèn)分為經(jīng)濟狀況好、中、差3個層次,每層隨機抽取1個鄉(xiāng)鎮(zhèn)作為研究點,得到3個鄉(xiāng)鎮(zhèn),每個鄉(xiāng)鎮(zhèn)隨機選取100名患者進行滿意度調(diào)查,共300人。 采用SPSS19.0和excel統(tǒng)計軟件對桑植縣新農(nóng)合的數(shù)據(jù)進行統(tǒng)計分析,并選用李永秋、張英潔的“新型農(nóng)村合作醫(yī)療補償模式綜合評價體系”的指標采用TOPSIS法與秩和比法對2010年-2012年桑植縣新農(nóng)合補償模式進行綜合評價。 結果：2012年湖南省桑植縣新農(nóng)合的參合率已經(jīng)達到98%,覆蓋了絕大部分農(nóng)村人口。2010年-2012年桑植縣新農(nóng)合基金籌資規(guī)模不斷擴大,結余率不斷下降,2012年為10.02%；平均住院天數(shù)有所增加,到2012年為10.31天；次均門診、住院費用有所上升；參合農(nóng)民受益面不斷擴大,補償率也增漲較快,到2012年門診補償率達到58.17%,住院補償率為61.86%,參合農(nóng)民自付門診、住院費用均有所下降；桑植縣參合農(nóng)民住院一般選擇鄉(xiāng)級醫(yī)院,約占52%,其次為縣級醫(yī)院,約為35%,在市、省級醫(yī)院住院的比例分別為5%、6.5%。 桑植縣新農(nóng)合改革患者滿意度調(diào)查結果顯示,患者總體滿意度較好,選擇“很滿意”和“較滿意”的占78.45%。“醫(yī)生診療水平”和“醫(yī)院衛(wèi)生環(huán)境水平”2個回答中的患者滿意度偏低,分別為65.96%和63.56%。患者對醫(yī)院總體較為滿意,但醫(yī)生的診療水平和衛(wèi)生狀況兩方面滿意度相對較低。在“您是否希望門診治療費用也采取病人支付一定數(shù)額費用后其余部分由新農(nóng)合全額報銷”的回答中,選擇“是的”和“最好免費”的占90.02%,絕大多數(shù)參合農(nóng)民希望門診也進行補償模式的改革。 結論：1.桑植縣新農(nóng)合補償模式的改革,提高了農(nóng)民在鄉(xiāng)鎮(zhèn)醫(yī)院住院的補償比例,參合農(nóng)民的次均門診和住院費用都有下降。2.通過TOPSIS法與秩和比法對補償模式的綜合評價結果顯示,補償模式的改革是有效果的,總體上是成功的。3.農(nóng)民在縣級以上醫(yī)院的住院費用還比較高,住院的醫(yī)療負擔還較重。
[Abstract]:Objective: by analyzing the present situation of the new rural cooperative medical system in Sanzhi County, Hunan Province, comprehensively evaluating the effect of the reform of the new rural cooperative medical system in Sangzhi County, and finding out the problems and shortcomings in the process of operation. It provides the basis and suggestion for the reform and perfection of the new rural cooperative compensation model in Sangzhi County. Methods: according to the purpose of the study, the relevant data were transferred from the "New Agricultural Cooperation Information Database" in Sanzhi County, Hunan Province to Excel, and then the data were proofread and analyzed. According to the level of local economic development and the annual per capita net income of rural residents, 39 villages and towns in Sangzhi County were divided into three groups: good economic status and good economic status. Three levels of difference, each level randomly selected a township as a research point, 3 villages and towns, each township randomly selected 100 patients for a survey of satisfaction, a total of 300 people. SPSS19.0 and excel software were used to analyze the data of Xinrong Cooperation in Sangzhi County, and Li Yongqiu was selected. Zhang Yingjie's "Comprehensive Evaluation system of New Rural Cooperative Medical compensation Model" used TOPSIS method and rank sum ratio method to comprehensively evaluate the new rural cooperative compensation model in Sangzhi County from 2010 to 2012. Results: in 2012, the participation rate of NCMS in Sangzhi County, Hunan Province had reached 98, covering the vast majority of the rural population. From 2010 to 2012, the New Rural Cooperation Fund (NRCF) in Sangzhi County, Hunan Province, continued to increase in scale of funding, and the balance rate continued to decline, which was 10.02 in 2012, with an increase in the average number of days of hospitalization. By 2012, the number of days was 10.31 days; the average number of outpatient visits was 10.31 days; the cost of hospitalization increased somewhat; the benefits of participating farmers continued to expand, and the compensation rate also increased rapidly. By 2012, the compensation rate for outpatient clinics had reached 58.17, and the compensation rate for hospitalization was 61.866.Participant farmers paid outpatient clinics on their own. The cost of hospitalization of farmers in Sanzhi County was decreased, and that of farmers in Sangzhi County was 52.The next was county hospital, about 35.The proportion of hospitalization in city and provincial hospital was 56.50.The cost of hospitalization in Sanzhi county was about 52%, and that of county hospital was about 35%, the proportion of hospitalization in city and provincial hospital was 5% and 6.5% respectively. The results of the survey on patients' satisfaction with the new rural cooperative reform in Sangzhi County showed that the overall satisfaction of patients was better. 78.45patients were selected as "very satisfied" and "more satisfied". The patients' satisfaction in "the level of doctor's diagnosis and treatment" and "the level of hygienic environment in the hospital" was 65.96% and 63.56, respectively. The patients were satisfied with the hospital as a whole. However, doctors' satisfaction with both the level of diagnosis and treatment and the state of health is relatively low. In the reply, "do you want outpatient treatment expenses to be reimbursed in full by NCMS after the patient has paid a certain amount of money?" "Yes" and "best free" account for 90.02 percent, and the vast majority of participating farmers hope that the out-patient service will also carry out compensation model reform. Conclusion 1. The reform of the new rural cooperative compensation model in Sangzhi County has increased the compensation ratio of farmers in township hospitals. The average outpatient and inpatient expenses of participating farmers have decreased. 2. The comprehensive evaluation results of compensation model by TOPSIS method and rank sum ratio method show that the reform of compensation mode is effective. Generally speaking, the cost of hospitalization of farmers in hospitals above county level is relatively high, and the burden of hospitalization is heavy.
【學位授予單位】：中南大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：F323.89;F842.684;R197.1

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