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目的了解新疆新型农牧区合作医疗(新农合)政策的实施现状及存在问题,为完善新农合制度提供相关建议。方法从新疆最早试点的13个县中,随机抽取6个县进行定量和定性调查。结果 2003—2009年样本县新农合的管理水平逐年增强,2009年较2005年筹资总额投入增加了262.02%,对新农合经办机构的拨款总额增长了54.43%,人员数均达到自治区编制标准;样本县新农合宣传工作力度逐年增强。参合农牧民住院及门诊补偿人次与补偿费用呈增长趋势,而门诊补偿比呈下降趋势;就诊患者对新农合政策总体满意者占76.87%;2009年各样本县农牧民参合率为98.65%~100.00%。结论政府应引导社会力量积极资助贫困农民参加新农合;建议增加各样本县新农合经办机构人员编制为6~9人,同时加大培训力度;加快新农合的信息化建设,提高新农合的管理能力和服务能力;依靠行政手段,实行多方参与,加大宣传力度。
Objective To understand the status quo and existing problems of the implementation of the New Cooperative Medical System (NRCMS) policy in Xinjiang’s new rural and pastoral areas and provide suggestions for improving the NCMS system. Methods From the first 13 counties in Xinjiang, six counties were randomly selected for quantitative and qualitative investigation. Results The management level of NCMS in sample counties increased year by year from 2003 to 2009, with an increase of 262.02% over the total funding in 2009 and a total increase of 54.43% in the total funding allocated to NCMS through the establishment of the autonomous region Standard; sample county NCMS propaganda efforts have been strengthened year by year. The attendance rates of outpatient visits and outpatient reimbursement for participation of farmers and herdsmen increased while the out-patient compensation rates showed a downward trend; 76.87% of the patients were satisfied with the new rural cooperative medical policy; in 2009, the participation rate of farmers and herdsmen in each sample county was 98.65 % ~ 100.00%. Conclusion The government should guide the social forces to actively subsidize the poor farmers to participate in the NCMS. It is proposed to increase the staffing of NCMS in each county by 6 to 9, and at the same time to increase training; speed up the NCMS’s information construction and increase NRCMS management capabilities and service capabilities; rely on administrative measures, the implementation of multi-party participation, increase publicity efforts.