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针对农村合作医疗解体后,基层对重新完成人人享有卫生保健战略目标中“集资医疗覆盖率达70％”指标所持的疑虑,岳阳县卫生局对4个不同自然、经济状况的村进行了集资医疗试点。结果表明经过强有力的领导、组织、宣传工作,引入科学化的管理指导,集资医疗仍得到了大多数村民的拥护,自愿参加者达70％以上。试点村的卫生服务利用增加,预防为主的方针得到了落实,平均医药费用降低,消费得到了正确的引导,解决了因病致贫的问题。试点经验还表明,要重建集资医疗制度,必须吸取以往合作医疗正反两方面的经验,重视解决下述问题:①坚持集体办医的模式;②集体须对集资医疗有一定比例的投入;③要建立有效的转诊体制;④公开办事程序,取信于民。
After the disintegration of rural cooperative medical care, the grassroots held doubts about the goal of “recovering 70% of fund-raising medical coverage” in the goal of resuming health care for all, and the Yueyang County Health Bureau raised funds for four villages with different natural and economic conditions. Medical pilot. The results show that after a strong leadership, organization, and propaganda work, the introduction of scientific management guidance, fund-raising of medical care has still been the support of most villagers, voluntary participants reached more than 70%. With the increase in the use of health services in pilot villages, the principle of prevention has been implemented, the average medical cost has been reduced, consumption has been properly guided, and poverty caused by illness has been resolved. Pilot experience also shows that in order to rebuild the fund-raising medical system, it is necessary to draw lessons from the positive and negative aspects of previous cooperative medical care, and pay attention to solving the following problems: (1) persist in the mode of collective medical treatment; (2) the collective must have a certain proportion of investment in fund-raising medical care; It is necessary to establish an effective referral system; 4 public procedures to win trust.