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目的:通过基线调查与5次追踪调查的比较,了解新型农村合作医疗制度(简称新农合)的实施对农民医疗费用的影响及其动态变化趋势,为进一步完善新农合的费用补偿实施方案提供科学依据。方法:采用多阶段分层整群随机抽样法抽取婺源县3个乡镇9个行政村,每村各取70户进行入户调查,将6次调查结果进行纵向对比研究。结果:本次调查农民年人均医疗费用为626.33元,其中门诊费用为284.14元,住院费用为342.19元,较往年均有较大幅度的上涨;住院费用的增高主要是20000元~费用段比例的增高所致;次均住院费用为历年最高,并随着医疗机构层次的增加而增加,尤其是县级以上医院;次均住院补偿费用亦为历年最高,但农民的自付住院费用亦上涨较快,农民的住院负担还是很大。结论:婺源县农民医疗费用上升较快,各级医疗机构的医疗费用大部分都未得到有效控制,尤其是县以上医院,新农合给农民带来的补偿,大部分被医疗费用上涨所抵消。必须采用多种有效措施严格控制医疗费用的增长。
Objective: To compare the baseline survey and five follow-up surveys to understand the impact of the implementation of the new rural cooperative medical system (NRCMS) on peasants’ medical costs and their dynamic trends. In order to further improve the NRCMS implementation plan Provide a scientific basis. Methods: The multi-stage stratified cluster random sampling method was used to extract 9 administrative villages in 3 towns and villages in Wuyuan County. Each village took 70 households for household survey, and the results of 6 surveys were compared vertically. Results: The annual per capita medical expenses for peasants was 626.33 yuan, of which 284.14 yuan was for outpatient service and 342.19 yuan for hospitalization, both of which were significantly higher than those of previous years. The increase of hospitalization expenses was mainly from 20000 yuan to expenses section The average cost of hospitalization was the highest in all the years and increased with the increase of the level of medical institutions, especially hospitals above the county level. The average cost of in-patient hospitalization was also the highest in all the years, but the cost of hospitalization by farmers also went up Fast, the burden of hospitalization of farmers is still great. Conclusion: The medical costs of peasants in Wuyuan County increased rapidly, and most of the medical expenses of medical institutions at all levels were not effectively controlled. Especially the compensation provided to peasants by hospitals and county far hospitals was mostly offset by the increase of medical expenses . A variety of effective measures must be taken to strictly control the growth of medical expenses.