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目的:研究新医改前后,山东省某市7个县新型农村合作医疗基金的生产率变化。方法:选取年参合人数、年筹资总额指标作为投入指标,选取各级医疗机构补偿总人次和补偿总额作为产出指标。利用Excel 2010建立数据库,使用DEAP2.1软件,分析7个县市的新型农村合作医疗基金全要素生产率变化、技术效率变化和技术进步变化。结果:在新医改后,新型农村合作医疗基金的全要素生产率呈降低趋势(tfpch改革前=1.314,tfpch改革后=1.103,t=3.533,P=0.006);新型农村合作医疗基金的技术效率变化不明显(effch改革前=1.037,effch改革后=1.001,t=1.560,P=0.085);新型农村合作医疗基金的技术进步显著降低(tech改革前=1.278,tech改革后=1.112,t=4.856,P=0.001);结论:山东省某市7个县新型农村合作医疗基金在新医改前后生产率变化明显,诸多新医改政策的层叠效应有效抑制了医疗服务供需双方的行为,不断攀升的次均住院补偿费用影响了基金的受益面,从而影响了新型农村合作医疗基金的使用效率。
Objective: To study the productivity changes of new rural cooperative medical funds in 7 counties in a city in Shandong Province before and after the new medical reform. Methods: Select the annual number of participants, the annual total amount of funding targets as an input index, select the total number of medical institutions at all levels of compensation and total compensation as output indicators. Using Excel 2010 to establish a database and DEAP2.1 software to analyze the changes of total factor productivity, technological efficiency and technological progress of the new rural cooperative medical fund in seven counties and cities. Results: After the new medical reform, the total factor productivity of the new rural cooperative medical fund showed a decreasing trend (tfpch = 1.314 before reform, tfpch = 1.103 after reform, t = 3.533, P = 0.006); the technical efficiency of new rural cooperative medical fund changed (Effch pre-reform = 1.037, effch post-reform = 1.001, t = 1.560, P = 0.085); the technological progress of the new rural cooperative medical fund was significantly reduced (pre-tech = 1.278, tech = 1.112, t = 4.856 , P = 0.001). Conclusion: The productivity of new-type rural cooperative medical funds in 7 counties in a certain city of Shandong province changed significantly before and after the new medical reform. The cascading effect of many new health care reform policies effectively suppressed the behaviors of both providers and consumers of medical services, Inpatient compensation costs affect the benefit side of the fund, thus affecting the efficiency of the new rural cooperative medical fund.