本文選題：中西醫(yī) + 藥物和療法補(bǔ)償��； 參考：《中國衛(wèi)生事業(yè)管理》2017年12期

【摘要】：目的:文章通過對比分析某市2011~2014年度醫(yī)療保險(xiǎn)對中西醫(yī)補(bǔ)償?shù)牟町?為完善中西醫(yī)補(bǔ)償政策提出建議。方法:利用Excel軟件對4年中西醫(yī)醫(yī)保補(bǔ)償?shù)恼獢?shù)據(jù)做描述性分析。結(jié)果:各年醫(yī)保對西醫(yī)藥物補(bǔ)償人次數(shù)所占比例約為46~48%,對西醫(yī)藥物補(bǔ)償費(fèi)用所占比例約為58~61%左右,對中醫(yī)藥物補(bǔ)償人次數(shù)所占比例約為12~13%左右,對中醫(yī)藥物補(bǔ)償費(fèi)用所占比例約為11~12%左右,對西醫(yī)療法補(bǔ)償人次數(shù)所占比例約為26~27%左右,對西醫(yī)療法補(bǔ)償費(fèi)用所占比例約為21~23%左右,對中醫(yī)療法補(bǔ)償人次數(shù)所占比例約為11~12%左右,對中醫(yī)療法補(bǔ)償費(fèi)用所占比例約為2~6%左右。2011~2014年中醫(yī)比西醫(yī)藥物醫(yī)保少補(bǔ)償?shù)娜舜螖?shù)比例差距擴(kuò)大了6.92個(gè)百分點(diǎn),少補(bǔ)償?shù)馁M(fèi)用比例差距擴(kuò)大了11.25個(gè)百分點(diǎn);中醫(yī)比西醫(yī)療法醫(yī)保少補(bǔ)償?shù)娜舜螖?shù)比例差距擴(kuò)大了10.83個(gè)百分點(diǎn),醫(yī)保少補(bǔ)償?shù)馁M(fèi)用比例差距擴(kuò)大了14.19個(gè)百分點(diǎn)。結(jié)論:各年度醫(yī)療保險(xiǎn)對中西醫(yī)藥物和療法的補(bǔ)償人次數(shù)和費(fèi)用的構(gòu)成比4年變化幅度不大;醫(yī)保補(bǔ)償以藥物補(bǔ)償為主,療法補(bǔ)償為輔;以西醫(yī)藥品和療法補(bǔ)償為主,以中醫(yī)藥物和療法的補(bǔ)償為輔。醫(yī)療保險(xiǎn)加大了對中醫(yī)的扶持力度,但中醫(yī)比西醫(yī)藥物和療法少補(bǔ)償人次數(shù)和費(fèi)用的比例差距仍然逐年擴(kuò)大。
[Abstract]:Objective: to compare and analyze the difference of medical insurance compensation between traditional Chinese and western medicine in a certain city in 2011and 2014, and put forward some suggestions for perfecting the policy of compensation between traditional Chinese and western medicine. Methods: Excel software was used to analyze the summary data of medical insurance compensation in 4 years. Results: the proportion of medical insurance compensation to western medicine was about 46 to 48 per year, the proportion of medical compensation to western medicine was about 58 to 61%, and the proportion of medical compensation to traditional Chinese medicine was about 12 to 13 percent. The proportion of compensatory expenses for traditional Chinese medicine is about 1112%, that for western medicine is about 26%, and that for western medicine is about 21 23%. The proportion of the number of patients compensated for TCM treatment was about 1112%, and the proportion of compensation expenses for TCM treatment was about 2%. From 2011 to 2014, the difference between the number of people compensated by TCM and medical insurance by western medicine increased by 6.92 percentage points. The difference in the proportion of expenses with less compensation was increased by 11.25 percentage points, the difference between the number of people who were compensated less by TCM than that by Western medicine was increased by 10.83 percentage points, and the difference in the proportion of expenses with less compensation by medical insurance was increased by 14.19 percentage points. Conclusion: the number and cost of medical insurance compensation for traditional Chinese and western medicine and therapy in each year is not much different from that in 4 years, the compensation of medical insurance mainly consists of drug compensation, medical compensation is supplemented by therapy compensation, and western medicine and therapy compensation is the main compensation. The compensation of traditional Chinese medicine and therapy is supplementary. Medical insurance has increased the support for TCM, but the gap between the number of people compensated and the cost of TCM less than that of western medicine and therapy is still widening year by year.
【作者單位】： 河南中醫(yī)藥大學(xué);
【基金】：河南省教育廳人文社科基地項(xiàng)目“醫(yī)療保險(xiǎn)對中醫(yī)藥衛(wèi)生服務(wù)影響研究”(編號:JD-2014-02) 河南中醫(yī)學(xué)院省屬高校基本科研業(yè)務(wù)費(fèi)專項(xiàng)項(xiàng)目“中醫(yī)藥NGO發(fā)展戰(zhàn)略研究”(編號:2014KYYWF-ZZCX3-12) 河南省衛(wèi)計(jì)委課題“促進(jìn)社會辦醫(yī)發(fā)展政策研究”(編號:YWZY201459)
【分類號】：F842.684;R197.1

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