【摘要】：自“新農(nóng)合”在樂清市實行以來,參合農(nóng)民受益面不斷擴大,他們在享受“新農(nóng)合”住院和報銷制度的同時,“新農(nóng)合”費用支出正逐年呈現(xiàn)上升趨勢,遏制醫(yī)療費用的不合理增長成為“新農(nóng)合”管理的重中之重。本文通過選擇樂清市某三乙醫(yī)院2013年1月1日-2013年12月31日期間入住的參加農(nóng)村合作醫(yī)療病人為樣本,采用SPSS軟件,對各項費用進行分析,描述醫(yī)療費用控制的現(xiàn)狀,測算和分析樂清市“新農(nóng)合”費用控制的初步效果。在此基礎上,提出樂清市“新農(nóng)合”費用控制中存在的問題及成因。 在借鑒國外及省外醫(yī)療費用控制特點的基礎上,對當前樂清市新型農(nóng)村合作醫(yī)療在其運行過程中的實施情況、影響因素、管理模式和監(jiān)督運行機制等方面進行整理和分析。 最后,分別從政府管理角度、醫(yī)院角度和住院病人角度提出控制“新農(nóng)合”費用的有效策略和措施。政府管理角度的對策有：多方位的定點醫(yī)療機構監(jiān)管機制的建立；明確籌資方式是突破籌資問題的有效手段；鼓勵發(fā)展城鄉(xiāng)醫(yī)療保險一體化建設和引入三方保險機制。醫(yī)院角度的對策有：加強醫(yī)療質量的管理,提高醫(yī)療服務水；推行綜合質量雙向考核機制；實行“新農(nóng)�！彼幤返倪M價與售價無差價銷售。住院病人角度的對策有：參合方認真學習和掌握“新農(nóng)合”保障機制的相關內(nèi)容和采取合適的醫(yī)療服務組合降低醫(yī)療費用支出。
[Abstract]:Since the implementation of "New Rural Cooperation" in Yueqing City, the benefits of participating farmers have been continuously expanded. While they enjoy the "New Rural Cooperation" hospitalization and reimbursement system, the expenses of "new rural cooperative cooperation" are showing an upward trend year by year. Curbing the unreasonable growth of medical expenses has become the top priority in the management of NCMS. In this paper, by selecting the rural cooperative medical care patients admitted from January 1, 2013 to December 31, 2013 in a third B Hospital in Yueqing City as samples, using SPSS software, the paper analyzes the various expenses and describes the current situation of medical cost control. Calculate and analyze the primary effect of cost control in Yueqing "New Rural Cooperation". On this basis, the paper puts forward the problems and causes in the cost control of Yueqing New Rural Cooperation. On the basis of drawing lessons from the characteristics of medical expenses control abroad and outside the province, this paper analyzes the implementation of the new rural cooperative medical system in Yueqing City in the process of its operation, the influencing factors, the management model and the supervision and operation mechanism, and so on. Finally, from the angle of government management, hospital and inpatient, the paper puts forward effective strategies and measures to control the cost of NCMS. The countermeasures from the angle of government management are as follows: the establishment of the supervision mechanism of multi-directional fixed-point medical institutions; the clear way of raising funds is an effective means to break through the problem of financing; the encouragement of the development of the integration of urban and rural medical insurance and the introduction of tripartite insurance mechanism. The countermeasures from the hospital point of view are as follows: strengthening the management of medical quality, improving medical service water, carrying out a comprehensive quality assessment mechanism, and carrying out the "New Rural Insurance" drug price and selling price without difference. The countermeasures of inpatients' angle are as follows: the participating parties study and master the relevant contents of the "New Rural Cooperation" security mechanism and adopt the appropriate combination of medical services to reduce the medical expenses.
【學位授予單位】：福建農(nóng)林大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：F842.684;F323.89;R197.1

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