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目的研究甘肃省卫生Ⅺ项目试点县新农合住院患者分流状况,找出存在的问题及原因,为完善新农合引导合理分流的机制、引导农民进行理性就医提出相应的对策建议。方法收集甘肃省新农合经办机构试点县2007—2013年《甘肃省新型农村合作医疗运行情况分析年报表》及相关文件资料进行统计分析。结果甘肃省县级及县级以上医疗机构住院人次和住院补偿资金占比逐年上升。2007—2013年的新农合住院人次,县级医院所占比例从46.21%上升至55.29%,县级以上医院所占比例从8.97%上升至27.59%,而乡镇卫生院所占比例下降了10.47个百分点;住院补偿资金,县级医院所占比例波动在40%~50%范围内,县级以上医疗机构所占比例波动在32%~42%,乡镇卫生院所占比例下降了11.52个百分点。结论甘肃省新型农村合作医疗并未起到引导住院患者合理分流的作用,新农合住院患者分流不合理现象严重,需进一步加强政策改革及监管,引导农村患者合理分流,使农村医疗服务资源得到合理配置,让农民获得更好的医疗服务。
Objective To study the patient diversion status of new rural cooperative medical institutions in Pilot County of Gansu Province, to find out the existing problems and causes. In order to improve the mechanism of NRCM to guide the rational diversion and guide farmers to seek rational medical treatment, some countermeasures and suggestions were put forward. Methods Collect Gansu Province, the new rural cooperative medical institutions pilot counties 2007-2013 “Gansu Province, new rural cooperative medical operation analysis of the annual report” and related documents for statistical analysis. Results The proportion of inpatient trips and hospitalization compensation funds in medical institutions at or above the county level in Gansu Province increased year by year. From 2007 to 2013, the number of NCMS residents increased from 46.21% to 55.29%, and the proportion of hospitals above the county level rose from 8.97% to 27.59%, while the proportion of township hospitals decreased by 10.47% Percentage points; hospitalization compensation funds, the proportion of county-level hospitals fluctuated within the range of 40% to 50%, the proportion of medical institutions above the county level fluctuations in the 32% to 42%, the proportion of township hospitals decreased by 11.52 percentage points . Conclusion Gansu Province, the new rural cooperative medical care did not play a role in guiding the rational diversion of inpatients, unreasonable diversion of patients in rural hospitals, the need to further strengthen policy reform and supervision, and guide rural patients to diversion, the rural medical service resources Reasonable allocation, so that farmers receive better medical services.