【摘要】：目的：通過(guò)對(duì)吉林省醫(yī)保體系的歷史發(fā)展和現(xiàn)狀進(jìn)行調(diào)查、分析，結(jié)合吉林省的實(shí)際情況，參考國(guó)際上的先進(jìn)經(jīng)驗(yàn)和國(guó)內(nèi)其它省市試點(diǎn)的經(jīng)驗(yàn)，探索適合我省實(shí)際情況的醫(yī)保城鄉(xiāng)統(tǒng)籌的機(jī)制。 方法：本研究通過(guò)文獻(xiàn)研究法、訪談法等方法對(duì)吉林省醫(yī)療保險(xiǎn)體系現(xiàn)狀進(jìn)行調(diào)查研究，采用描述性分析、秩和檢驗(yàn)等統(tǒng)計(jì)方法對(duì)肺癌患者數(shù)據(jù)、2007-2012年吉林省新農(nóng)合患者在不同級(jí)別醫(yī)療機(jī)構(gòu)就醫(yī)的數(shù)據(jù)進(jìn)行處理，采取文獻(xiàn)研究法和非結(jié)構(gòu)型訪談法對(duì)長(zhǎng)春市朝陽(yáng)區(qū)的試點(diǎn)情況進(jìn)行研究。 結(jié)果：城鎮(zhèn)職工醫(yī)療保險(xiǎn)的各方面待遇遠(yuǎn)高于其它醫(yī)保。城鎮(zhèn)居民醫(yī)療保險(xiǎn)和新農(nóng)合在總費(fèi)用、住院天數(shù)、自費(fèi)費(fèi)用、自費(fèi)比例、報(bào)銷費(fèi)用、報(bào)銷比例等方面比較接近，無(wú)顯著差異。城鄉(xiāng)統(tǒng)籌試點(diǎn)的朝陽(yáng)區(qū)為新農(nóng)合患者的醫(yī)療與報(bào)銷提供了方便，但是降低了患者的待遇。2007-2012年，吉林省新農(nóng)合患者在各級(jí)醫(yī)療機(jī)構(gòu)就醫(yī)時(shí)，住院次均費(fèi)用、住院次均自費(fèi)費(fèi)用、補(bǔ)償比例逐年提升。在基層醫(yī)療機(jī)構(gòu)就醫(yī)的患者逐年減少，到縣級(jí)及縣級(jí)以上醫(yī)療機(jī)構(gòu)就醫(yī)的患者逐年增多�；鶎俞t(yī)療機(jī)構(gòu)在醫(yī)�；鹬兴嫉姆蓊~逐年遞減，縣級(jí)醫(yī)療機(jī)構(gòu)所占份額逐年上升，縣以上醫(yī)療機(jī)構(gòu)所占份額基本保持不變。 結(jié)論：實(shí)施醫(yī)保城鄉(xiāng)統(tǒng)籌，可以解決省內(nèi)流動(dòng)人口醫(yī)保關(guān)系的轉(zhuǎn)移接續(xù)問(wèn)題；可以縮短城鄉(xiāng)差距，，體現(xiàn)公共服務(wù)均等化的理念；可以加強(qiáng)對(duì)醫(yī)�；鸬谋O(jiān)管和對(duì)騙保行為的打擊力度；可以擴(kuò)大省內(nèi)各統(tǒng)籌地區(qū)的醫(yī)�；鹨�(guī)模。
[Abstract]:Objective: through the investigation and analysis of the historical development and present situation of the medical insurance system in Jilin Province, combined with the actual situation of Jilin Province, referring to the advanced international experience and the experience of other provinces and cities in China, Explore the medical insurance urban and rural overall planning mechanism suitable for the actual situation of our province. Methods: this study investigated the present situation of medical insurance system in Jilin Province by means of literature research and interview, and used descriptive analysis, rank sum test and other statistical methods to analyze the data of patients with lung cancer. From 2007 to 2012, the data of NCMS patients in different levels of medical institutions in Jilin Province were processed, and the pilot situation of Chaoyang District of Changchun City was studied by means of literature research and unstructured interview. Results: the treatment of medical insurance for urban workers was much higher than that of other medical insurance. There is no significant difference between urban residents' medical insurance and NCMS in terms of total expenses, hospitalization days, self-expenses, proportion of self-expenses, reimbursement ratio and so on. Chaoyang District, which is a pilot project in urban and rural areas, provides convenience for the medical treatment and reimbursement of NCMS patients, but reduces the treatment of patients. From 2007 to 2012, the average cost of hospitalization of NCMS patients in medical institutions at all levels in Jilin Province was average. Hospitalization expenses are all at their own expense, and the proportion of compensation is increasing year by year. The number of patients seeking medical treatment in primary medical institutions is decreasing year by year, and the number of patients going to county-level and above medical institutions is increasing year by year. The share of primary medical institutions in medical insurance funds is decreasing year by year, the share of county-level medical institutions is increasing year by year, and the share of medical institutions above county level is basically unchanged. Conclusion: the implementation of medical insurance as a whole between urban and rural areas can solve the problem of transferring and continuing the relationship of medical insurance for floating population in the province, shorten the gap between urban and rural areas, and embody the concept of equal public service. It can strengthen the supervision of health insurance funds and crack down on insurance fraud, and can expand the scale of health insurance funds in all areas of the province.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R197.1;F842.684

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 韓俊江;胡丹;;創(chuàng)新醫(yī)保支付方式化解“看病貴”探析——以長(zhǎng)春市醫(yī)療保險(xiǎn)支付方式改革為例[J];東北師大學(xué)報(bào)(哲學(xué)社會(huì)科學(xué)版);2012年02期

2 徐麗;;老齡化趨勢(shì)給醫(yī)�；饚�(lái)的挑戰(zhàn)及對(duì)策分析——以上海為例[J];經(jīng)濟(jì)問(wèn)題探索;2005年12期

3 廖丹萍;邸信;;城鄉(xiāng)居民醫(yī)療保險(xiǎn)管理機(jī)構(gòu)的過(guò)渡問(wèn)題研究[J];技術(shù)與市場(chǎng);2011年06期

4 撫順市社會(huì)科學(xué)院課題組;曹陽(yáng);劉士全;;遼寧省城鎮(zhèn)職工、城鎮(zhèn)居民和農(nóng)村醫(yī)療保險(xiǎn)一體化建設(shè)[J];理論界;2011年04期

5 譚麗;;社會(huì)保險(xiǎn)法適用標(biāo)準(zhǔn)的細(xì)化問(wèn)題探析[J];經(jīng)濟(jì)與管理;2012年07期

6 鐘潔;劉芳;;海南省社會(huì)醫(yī)療保險(xiǎn)城鄉(xiāng)統(tǒng)籌的思考[J];海南金融;2013年01期

7 王敏;張開(kāi)金;姜麗;邱曉艷;;門(mén)診統(tǒng)籌模式的建立與思考[J];中國(guó)全科醫(yī)學(xué);2009年07期

8 仇雨臨;郝佳;;城鄉(xiāng)醫(yī)療保障制度統(tǒng)籌發(fā)展的路徑研究——基于東莞、太倉(cāng)、成都和西安的實(shí)地調(diào)研[J];人口與經(jīng)濟(jì);2011年04期

9 李孜;楊潔敏;;我國(guó)城市流動(dòng)人口醫(yī)療保障模式比較研究——以上海、成都、北京、深圳為例[J];人口研究;2009年03期

10 張艷紅;徐凌忠;趙偉寧;;山東省農(nóng)村居民就醫(yī)流向分析[J];社區(qū)醫(yī)學(xué)雜志;2011年21期

相關(guān)博士學(xué)位論文 前3條

1 何軍;城鄉(xiāng)統(tǒng)籌背景下的勞動(dòng)力轉(zhuǎn)移與城市融入問(wèn)題研究[D];南京農(nóng)業(yè)大學(xué);2011年

2 王歡;全民醫(yī)保目標(biāo)下醫(yī)療保障制度底線公平研究[D];華中科技大學(xué);2009年

3 林娣;宏觀視角下農(nóng)民工醫(yī)療保障制度研究[D];復(fù)旦大學(xué);2012年

相關(guān)碩士學(xué)位論文 前3條

1 石靜;重慶市統(tǒng)籌城鄉(xiāng)醫(yī)療保險(xiǎn)制度研究[D];重慶大學(xué);2010年

2 譚一夫;農(nóng)村醫(yī)療衛(wèi)生保障有效供給研究[D];西南財(cái)經(jīng)大學(xué);2012年

3 李俊;商業(yè)保險(xiǎn)公司參與社會(huì)醫(yī)療保險(xiǎn)管理的模式研究[D];西南財(cái)經(jīng)大學(xué);2012年

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