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目的利用集中指数和集中曲线分析四川省富顺县2015年新型农村合作医疗住院受益公平性,为进一步完善政策提供参考。方法采用多阶段分层随机抽样,抽取四川省富顺县3镇12村的农村居民进行结构式问卷访谈,采用家庭资产评估法对参加新农合的居民进行经济分组并计算住院率、应住院未住院率、住院补偿率和人均补偿比的集中指数并绘制集中曲线,以分析新农合对不同经济水平参保人群住院受益的公平性。结果住院服务利用方面,住院率、应住院未住院率的集中指数分别为-0.0974、-0.1717,二者的分布随着经济水平的降低均呈现增高趋势且应住院未住院的不公平程度较为严重;住院补偿方面,住院补偿率和人均补偿比的集中指数分别为-0.0017、-0.0634,住院是否获得补偿在人群中分布较为公平,而补偿费用占住院费用的比值在低收入人群中更高。结论新农合能有效保证低收入人群对住院医疗服务的利用,但应住院未住院的情况在低收入人群中更为突出;低收入人群获得补偿率和人均补偿比较高,但人群总体补偿比偏低。
Objective To analyze the fairness of hospitalization benefit of 2015 new-type rural cooperative medical system in Fushun County, Sichuan Province by using the concentration index and concentration curve, and provide reference for further improving the policy. Methods Using multi-stage stratified random sampling, rural residents in 12 villages of 3 towns in Fushun County of Sichuan Province were selected to conduct structured questionnaire interview. Family assets evaluation method was adopted to divide the residents participating in NRCMS into groups and calculate the hospitalization rate. Rate, hospitalization compensation rate and per capita compensation ratio of the concentration index and draw a concentration curve to analyze the NCMS for the insurance of people with different economic levels of hospitalization benefit fair. Results As for the utilization of hospital services, the concentration indices of inpatient rates and inpatient uninhabited rates were -0.0974 and -0.1717, respectively. Both of them showed an increasing trend as the economic level decreased, and the degree of unfairness should not be hospitalized Inpatient compensation, the concentration index of inpatient compensation rate and per capita compensation ratio were -0.0017 and -0.0634 respectively. It is more fair to find out whether hospitalization is compensated and the ratio of compensation to hospitalization is higher among low-income groups. Conclusion The NRCMS can effectively ensure the utilization of hospitalized medical services for low-income groups, but should not be hospitalized in low-income groups. The compensation rate and per capita compensation for low-income groups are higher, but the overall compensation ratio Low.