本文選題：醫(yī)療保險(xiǎn)一體化 + 城鄉(xiāng)居民醫(yī)療保險(xiǎn)��； 參考：《西北大學(xué)》2013年碩士論文

【摘要】：由于長期以來城鄉(xiāng)經(jīng)濟(jì)發(fā)展水平的不同,二元經(jīng)濟(jì)社會(huì)成為我國的典型表現(xiàn)�，F(xiàn)階段我國的社會(huì)醫(yī)療保險(xiǎn)也是處于城鄉(xiāng)有別的狀態(tài),但是隨著社會(huì)經(jīng)濟(jì)的變化,國家政策對于醫(yī)保的調(diào)整方向有所改變。從2003年“統(tǒng)籌城鄉(xiāng)發(fā)展”的提出,到2009年新醫(yī)改的全面展開,再到2012年十八大報(bào)告中對“加大統(tǒng)籌城鄉(xiāng)發(fā)展力度,促進(jìn)城鄉(xiāng)共同繁榮”的再次強(qiáng)調(diào),城鄉(xiāng)居民醫(yī)療保險(xiǎn)一體化的試點(diǎn)開始陸續(xù)出現(xiàn)。 本文以我國城鄉(xiāng)基本醫(yī)療保險(xiǎn)一體化改革現(xiàn)狀的分析為基礎(chǔ),對旬邑縣“城鄉(xiāng)居民新型合作醫(yī)療”與就原來的醫(yī)療保險(xiǎn)(新型農(nóng)村合作醫(yī)療制度和城鎮(zhèn)居民基本醫(yī)療制度)在參保對象、籌資標(biāo)準(zhǔn)、待遇標(biāo)準(zhǔn)、經(jīng)辦機(jī)構(gòu)、基金管理、網(wǎng)絡(luò)建設(shè)六方面進(jìn)行了比較和分析后,指出新政策實(shí)現(xiàn)了城鄉(xiāng)居民的全體覆蓋、提高了居民醫(yī)療保險(xiǎn)待遇和參保積極性,增強(qiáng)了基金的抗風(fēng)險(xiǎn)能力,并且為城鎮(zhèn)居民就醫(yī)提供了極大便利。 其次,根據(jù)旬邑縣城鄉(xiāng)居民新型合作醫(yī)療經(jīng)辦中心所提供的數(shù)據(jù),本文從參保狀況、患者流向、基金的使用和分配、人群受益情況四方面入手,具體的對比分析了2010年-2012年各個(gè)方面數(shù)據(jù)的增長與變化。得出以下結(jié)論：旬邑縣城鄉(xiāng)居民新型合作醫(yī)療提高了居民參保積極性與人群受益度；合理分配了患者流向,促進(jìn)了基層衛(wèi)生事業(yè)的良性發(fā)展；提高了基金的使用效率,使基金分配趨于合理；逐步提高了參保人群受益度,減輕了居民看病負(fù)擔(dān)；促進(jìn)了城鄉(xiāng)協(xié)調(diào)發(fā)展、符合社會(huì)發(fā)展要求。 最后,結(jié)合我國不同試點(diǎn)運(yùn)行情況和對旬邑縣改革效果的分析,本文建議,若想更好更平穩(wěn)的進(jìn)行城鄉(xiāng)基本醫(yī)療保險(xiǎn)一體化改革,可以同步推行以下方面：將商業(yè)保險(xiǎn)機(jī)制引入城鄉(xiāng)基本醫(yī)療保險(xiǎn)體系中,提高居民保障水平；將衛(wèi)生部門作為主管部門統(tǒng)一管理城鄉(xiāng)基本醫(yī)療保險(xiǎn)的運(yùn)行實(shí)施；同步推進(jìn)戶籍制度改革,打破城鄉(xiāng)分割的局面；因地制宜,在整合過程中逐步統(tǒng)一繳費(fèi)與待遇支付水平；加強(qiáng)基層人才隊(duì)伍建設(shè),提高基層醫(yī)療衛(wèi)生服務(wù)水平。
[Abstract]:For a long time, dual economy society has become the typical performance of our country because of the different development level of urban and rural economy. At present, the social medical insurance of our country is also in a different state of urban and rural areas, but with the change of social economy, the adjustment direction of national policy on medical insurance has changed. From the proposal of "coordinating urban and rural development" in 2003, to the comprehensive development of the new medical reform in 2009, to the report of the 18th National Congress of 2012 on "strengthening the overall planning of urban and rural development and promoting the common prosperity of urban and rural areas", Urban and rural residents of medical insurance integration of the pilot began to appear one after another. This paper is based on the analysis of the status quo of the reform of basic medical insurance in urban and rural areas. To Xunyi county "urban and rural residents new cooperative medical care" and the original medical insurance (new rural cooperative medical care system and the basic medical care system of urban residents) in the insured object, funding standards, treatment standards, agencies, fund management, After comparing and analyzing the six aspects of network construction, it is pointed out that the new policy has realized the overall coverage of urban and rural residents, improved the residents' medical insurance treatment and enthusiasm for participating in insurance, and strengthened the fund's ability to resist risks. It also provides great convenience for urban residents to seek medical treatment. Secondly, according to the data provided by Xunyi urban and rural residents' new cooperative medical service center, this paper starts from four aspects: the status of insurance participation, the flow of patients, the use and distribution of funds, and the benefits of the crowd. The specific comparative analysis of the 2010-2012 data growth and change in all areas. Draw the following conclusions: Xunyi urban-rural residents of the new cooperative medical care to improve the enthusiasm of residents and the benefits of the population; reasonable distribution of patients, promote the benign development of grass-roots health services; improve the efficiency of the use of funds, The distribution of funds tends to be reasonable; the benefit degree of insured population is raised step by step; the burden of medical treatment of residents is reduced; the coordinated development of urban and rural areas is promoted, which conforms to the requirements of social development. Finally, combined with the operation of different pilot projects in China and the analysis of Xunyi County reform effect, this paper suggests that, if we want to better and more smoothly carry out the urban and rural basic medical insurance integration reform, The following aspects can be implemented simultaneously: introducing the commercial insurance mechanism into the urban and rural basic medical insurance system to improve the residents' security level, taking the health sector as the competent department to uniformly manage the operation and implementation of the basic medical insurance in urban and rural areas; Simultaneously promote the reform of household registration system, break the situation of urban and rural segmentation; adjust measures to local conditions, gradually unified payment and treatment payment level in the process of integration; strengthen the construction of grass-roots talent team, improve the basic level of medical and health services.
【學(xué)位授予單位】：西北大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：F842.684

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本文編號：1981493