新農(nóng)合引入商業(yè)保險案例分析和應(yīng)用研究
發(fā)布時間：2019-06-27 16:53
【摘要】：我國自2003年推行新型農(nóng)村合作醫(yī)療制度以來,農(nóng)民參合率逐年增加,籌資水平大幅提升,參合農(nóng)民受益面不斷擴(kuò)大,保障水平顯著提高,切實減輕了農(nóng)民的就醫(yī)負(fù)擔(dān),使農(nóng)民在獲得基本醫(yī)療衛(wèi)生保障方面發(fā)揮了重要的作用。某市目前各區(qū)縣新農(nóng)合人均籌資額在全國居于先進(jìn)行列,保障水平的大幅度提高使得參合農(nóng)民的滿意率穩(wěn)定提高。 但是在新農(nóng)合的發(fā)展中也存在著諸如醫(yī)療費用上漲、醫(yī)療行為不當(dāng)?shù)纫恍┎蝗莺鲆暤膯栴},為了解決這些問題,提高保險資金的使用效率以避免浪費,全國的許多地區(qū)嘗試引入市場機(jī)制參與到醫(yī)療保險中來合作進(jìn)行管理和經(jīng)辦。2002年開始,各地就已紛紛開展委托專業(yè)商業(yè)保險機(jī)構(gòu)來參與經(jīng)辦農(nóng)村合作醫(yī)療的做法,并且取得了較好的效果,農(nóng)民參合率進(jìn)一步上升,籌資和保障水平較之前都有大幅提高,減輕了農(nóng)民群眾的就醫(yī)負(fù)擔(dān)。 目前某市的新農(nóng)合工作尚未在全區(qū)縣范圍內(nèi)都開展引入商業(yè)保險的合作模式,僅有某區(qū)的新農(nóng)合采用了這種合作模式。雖然該區(qū)開展這種合作模式的時間不是很長,但是此模式的引用對該區(qū)農(nóng)民醫(yī)療費用支出的改善已初見成效。 本文主要通過對在某市某區(qū)進(jìn)行新農(nóng)合引入商業(yè)保險機(jī)構(gòu)參與經(jīng)辦改革作為試點案例進(jìn)行研究,將新農(nóng)合引入商業(yè)保險機(jī)構(gòu)參與管理經(jīng)辦前后的情況進(jìn)行對比分析,通過理論分析與實效分析相結(jié)合的方法,論證引入商業(yè)保險后的新農(nóng)合對農(nóng)民醫(yī)療費用支出的改進(jìn)的效果。結(jié)合從參保農(nóng)民、政府衛(wèi)生部門、商業(yè)保險機(jī)構(gòu)等角度分析新農(nóng)合引入商保模式的優(yōu)勢,探討引入商保模式在全市范圍內(nèi)的可推廣性。希望對全市在新農(nóng)合工作中引入該模式提供一定參考價值。
[Abstract]:Since the implementation of the new rural cooperative medical system in 2003, the participation rate of farmers has increased year by year, the level of financing has been greatly improved, the benefits of participating farmers have been continuously expanded, the level of security has been significantly improved, the burden of seeking medical treatment has been effectively reduced, and farmers have played an important role in obtaining basic medical and health security. At present, the per capita fund raising amount of NCMS in a certain city is in the advanced ranks of the whole country, and the satisfaction rate of participating farmers is steadily improved with the great improvement of the guarantee level. However, in the development of NCMS, there are also some problems that can not be ignored, such as rising medical expenses and improper medical behavior. in order to solve these problems and improve the efficiency of the use of insurance funds in order to avoid waste, many parts of the country have tried to introduce market mechanisms to participate in the management and operation of medical insurance. Since 2002, Various localities have carried out the practice of entrusting professional commercial insurance institutions to participate in the operation of rural cooperative medical care, and have achieved good results. The participation rate of farmers has further increased, and the level of financing and security has been greatly improved, thus reducing the burden on the masses of farmers to seek medical treatment. At present, the new rural cooperative work in a city has not yet carried out the cooperation mode of introducing commercial insurance in the whole district and county, and only the new NCMS in a certain area has adopted this cooperative mode. Although the cooperation model has not been carried out for a long time, the introduction of this model has achieved initial results in the improvement of farmers' medical expenses in this area. In this paper, through the pilot case study of the introduction of commercial insurance institutions into the reform of commercial insurance institutions in a certain district of a city, this paper makes a comparative analysis of the situation before and after the introduction of new agricultural cooperation institutions into commercial insurance institutions, and demonstrates the effect of the introduction of commercial insurance institutions on the improvement of farmers' medical expenses through the combination of theoretical analysis and actual effect analysis. Based on the analysis of the advantages of the introduction of commercial insurance model from the angles of insured farmers, government health departments and commercial insurance institutions, this paper probes into the extensibility of introducing commercial insurance model in the whole city. It is hoped that it will provide certain reference value for the whole city to introduce this model into the new agricultural cooperative work.
【學(xué)位授予單位】：首都經(jīng)濟(jì)貿(mào)易大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：F323.89;F842.684
本文編號：2506979
[Abstract]:Since the implementation of the new rural cooperative medical system in 2003, the participation rate of farmers has increased year by year, the level of financing has been greatly improved, the benefits of participating farmers have been continuously expanded, the level of security has been significantly improved, the burden of seeking medical treatment has been effectively reduced, and farmers have played an important role in obtaining basic medical and health security. At present, the per capita fund raising amount of NCMS in a certain city is in the advanced ranks of the whole country, and the satisfaction rate of participating farmers is steadily improved with the great improvement of the guarantee level. However, in the development of NCMS, there are also some problems that can not be ignored, such as rising medical expenses and improper medical behavior. in order to solve these problems and improve the efficiency of the use of insurance funds in order to avoid waste, many parts of the country have tried to introduce market mechanisms to participate in the management and operation of medical insurance. Since 2002, Various localities have carried out the practice of entrusting professional commercial insurance institutions to participate in the operation of rural cooperative medical care, and have achieved good results. The participation rate of farmers has further increased, and the level of financing and security has been greatly improved, thus reducing the burden on the masses of farmers to seek medical treatment. At present, the new rural cooperative work in a city has not yet carried out the cooperation mode of introducing commercial insurance in the whole district and county, and only the new NCMS in a certain area has adopted this cooperative mode. Although the cooperation model has not been carried out for a long time, the introduction of this model has achieved initial results in the improvement of farmers' medical expenses in this area. In this paper, through the pilot case study of the introduction of commercial insurance institutions into the reform of commercial insurance institutions in a certain district of a city, this paper makes a comparative analysis of the situation before and after the introduction of new agricultural cooperation institutions into commercial insurance institutions, and demonstrates the effect of the introduction of commercial insurance institutions on the improvement of farmers' medical expenses through the combination of theoretical analysis and actual effect analysis. Based on the analysis of the advantages of the introduction of commercial insurance model from the angles of insured farmers, government health departments and commercial insurance institutions, this paper probes into the extensibility of introducing commercial insurance model in the whole city. It is hoped that it will provide certain reference value for the whole city to introduce this model into the new agricultural cooperative work.
【學(xué)位授予單位】：首都經(jīng)濟(jì)貿(mào)易大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：F323.89;F842.684
【引證文獻(xiàn)】
相關(guān)期刊論文 前2條
1 吳海波;;健康險參與基本醫(yī)療保障經(jīng)辦管理服務(wù)模式比較研究[J];國外醫(yī)學(xué)(衛(wèi)生經(jīng)濟(jì)分冊);2014年02期
2 侯珊芳;雷寒;;新形勢下社會醫(yī)療保險和商業(yè)健康保險的合作模式探析[J];重慶醫(yī)學(xué);2015年28期
，本文編號：2506979
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