本文選題：農(nóng)村合作醫(yī)療　切入點(diǎn)：農(nóng)村醫(yī)療保險(xiǎn)　出處：《西北農(nóng)林科技大學(xué)》2013年碩士論文

【摘要】：中國(guó)農(nóng)村合作醫(yī)療制度自20世紀(jì)50年代創(chuàng)建以來(lái)已有60多年的歷史,經(jīng)過(guò)前期的蓬勃發(fā)展,到了80年代開(kāi)始衰退。2003年國(guó)務(wù)院選擇在部分省的部分市(縣)進(jìn)行新型農(nóng)村合作醫(yī)療制度的試點(diǎn)工作,并于2010年在全國(guó)范圍內(nèi)展開(kāi)。新型農(nóng)村合作醫(yī)療在吳江區(qū)運(yùn)行期間許多問(wèn)題已經(jīng)顯現(xiàn)出來(lái),文章通過(guò)采用歷史回顧和現(xiàn)狀評(píng)價(jià)相結(jié)合法、社會(huì)學(xué)田野調(diào)查方法、定性和定量分析法對(duì)這些問(wèn)題進(jìn)行了研究,主要從六個(gè)方面闡述了吳江區(qū)農(nóng)村合作醫(yī)療存在的問(wèn)題。首先人才供給不足。其次政策制定缺乏合理性,吳江區(qū)合管辦對(duì)醫(yī)療基金的管理缺乏科學(xué)的測(cè)算。再次籌資水平底,抗風(fēng)險(xiǎn)能力有限,在目前政府財(cái)力有限的情況下,只能根據(jù)籌資水平來(lái)合理確定補(bǔ)償標(biāo)準(zhǔn),補(bǔ)償?shù)目傎M(fèi)用不能超出基金的總額。第四點(diǎn)是報(bào)銷額度低,救助待遇差。主要體現(xiàn)在與城鎮(zhèn)職工醫(yī)療保險(xiǎn)比較后的差距。第五點(diǎn)是醫(yī)療機(jī)構(gòu)存在的問(wèn)題,主要是定點(diǎn)醫(yī)療機(jī)構(gòu)選擇面臨兩難,醫(yī)療機(jī)構(gòu)本身也注重利益。第六點(diǎn)可持續(xù)問(wèn)題凸顯,隨著籌資水平的連年提高和將特殊人群免繳個(gè)人費(fèi)用納入保障范圍之內(nèi),吳江區(qū)地方政府的壓力也逐年增大。 通過(guò)闡述這五個(gè)問(wèn)題,文章提出了完善吳江區(qū)農(nóng)村合作醫(yī)療制度的建議。通過(guò)引進(jìn)專項(xiàng)人才,同時(shí)對(duì)現(xiàn)有在崗人員進(jìn)行專業(yè)技術(shù)培訓(xùn),來(lái)加強(qiáng)人才隊(duì)伍建設(shè)；通過(guò)將鎮(zhèn)級(jí)基金并入?yún)^(qū)級(jí)基金,統(tǒng)籌運(yùn)作,從而建立穩(wěn)定的籌資機(jī)制；通過(guò)政務(wù)公開(kāi)、實(shí)施崗位責(zé)任制考核、加強(qiáng)審計(jì)來(lái)加大考核監(jiān)察力度；通過(guò)加快新農(nóng)合與職工醫(yī)療保險(xiǎn)并軌的速度來(lái)縮小兩者的差距；通過(guò)從各方面加強(qiáng)定點(diǎn)醫(yī)療機(jī)構(gòu)建設(shè)來(lái)完善吳江的定點(diǎn)醫(yī)療機(jī)構(gòu)；通過(guò)政府、農(nóng)戶、合作醫(yī)療管理機(jī)構(gòu)、醫(yī)療服務(wù)機(jī)構(gòu)四個(gè)要素來(lái)構(gòu)建完整的合作醫(yī)療支撐體系。旨在為政府決策提供一些可參考的建議。
[Abstract]:China's rural cooperative medical system has a history of more than 60 years since it was established in the 1950s. In the 1980s, the recession began. In 2003, the State Council chose to pilot the new rural cooperative medical system in some cities (counties) of some provinces. During the operation of the new rural cooperative medical system in Wu Jiang District, many problems have been revealed. The article adopts the method of historical review and current situation evaluation, and sociological field investigation method. The qualitative and quantitative analysis method has carried on the research to these questions, mainly elaborated from six aspects the existence question of Wu Jiang area rural cooperative medical system. First, the talented person supply is insufficient, secondly the policy formulation lacks the rationality, Wu Jiang's Regional Cooperative Management Office lacks scientific calculation of the management of medical funds. At the bottom of the level of refinancing, the ability to resist risks is limited. Under the current situation of limited government financial resources, compensation standards can only be reasonably determined according to the level of funding. The total cost of compensation cannot exceed the total amount of the fund. The fourth point is that the amount of reimbursement is low, and the treatment of relief is poor. It is mainly reflected in the gap after comparing with the medical insurance of urban workers. The fifth point is the problem existing in medical institutions. The main problem is that the choice of designated medical institutions is faced with a dilemma, and the medical institutions themselves also pay attention to interests. Sixth, the sustainability issue highlights, as the level of funding increases year after year and the exemption of special people from personal expenses is included in the scope of protection. Wu Jiang area local government pressure also increases year by year. Through expounding these five problems, the paper puts forward some suggestions to perfect the rural cooperative medical system in Wu Jiang district, and strengthens the construction of talent team by introducing special talents and carrying on professional technical training to the existing staff in the post at the same time; By merging the township fund into the district level fund and coordinating the operation, a stable financing mechanism is established, and the examination of post responsibility system is carried out through the opening of government affairs and the strengthening of audit to strengthen the examination and supervision. By speeding up the integration of NCMS and employee medical insurance, to narrow the gap between the two; to perfect Wu Jiang's designated medical institutions by strengthening the construction of designated medical institutions in all aspects; to improve Wu Jiang's designated medical institutions through the government, farmers, and cooperative medical management institutions. The four elements of medical service organization are to construct a complete cooperative medical care support system, which aims to provide some suggestions for government decision making.
【學(xué)位授予單位】：西北農(nóng)林科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：F842.684;R197.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張屹立;;新農(nóng)村公共衛(wèi)生服務(wù)體系構(gòu)建中的政府職責(zé)[J];安徽農(nóng)業(yè)科學(xué);2009年15期

2 陳健生;新型農(nóng)村合作醫(yī)療籌資制度的設(shè)計(jì)與改進(jìn)[J];財(cái)經(jīng)科學(xué);2005年01期

3 王思斌;;農(nóng)村社會(huì)保障制度建設(shè)的政策過(guò)程分析[J];文史博覽;2005年Z2期

4 林淑周;;論農(nóng)民在新型農(nóng)村合作醫(yī)療中的角色——社會(huì)政策的視角[J];福建行政學(xué)院福建經(jīng)濟(jì)管理干部學(xué)院學(xué)報(bào);2007年06期

5 李衛(wèi)平,石光,趙琨;我國(guó)農(nóng)村衛(wèi)生保健的歷史、現(xiàn)狀與問(wèn)題[J];管理世界;2003年04期

6 楊團(tuán);;從新型農(nóng)村合作醫(yī)療試點(diǎn)看農(nóng)村衛(wèi)生政策的完善[J];紅旗文稿;2004年02期

7 代志明,何洋;國(guó)外農(nóng)村醫(yī)療保障制度的解讀與借鑒[J];經(jīng)濟(jì)縱橫;2005年02期

8 朱玲;鄉(xiāng)村醫(yī)療保險(xiǎn)和醫(yī)療救助[J];金融研究;2000年05期

9 石擁軍;農(nóng)村合作醫(yī)療管理探討──合作醫(yī)療發(fā)展30年回顧與思考[J];江蘇衛(wèi)生事業(yè)管理;2001年05期

10 饒江紅,劉雪斌,胡延慶;農(nóng)村醫(yī)療保障制度模式選擇的比較研究[J];南昌大學(xué)學(xué)報(bào)(人文社會(huì)科學(xué)版);2003年06期

，

本文編號(hào)：1698657