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目的:评价三种新型农村合作医疗经办模式下新农合支付方式改革对医疗费用控制效果,为进一步推进新农合支付方式改革提供依据。方法:采用文献分析法和专家小组讨论法确定支付方式控制医疗费用的评价指标,在此基础上运用秩和比法和TOPSIS法进行评价。结果:三种经办模式下,对门诊和住院医疗费用控费效果最优的支付方式存在一定的差异性。结论:医疗费用控费效果最优的支付方式充分考虑到了其经办模式所涉及的主要利益相关者及其战略利益诉求,进而才能实现控制新农合医疗费用不合理增长的目的。
OBJECTIVE: To evaluate the effectiveness of the reform of the new rural cooperative medical system on the medical costs under the three new rural cooperative medical modes of operation, and provide the basis for further promoting the reform of the new rural cooperative medical system. Methods: By using the method of literature analysis and expert panel discussion, the evaluation index of controlling the medical expenses by payment method was determined. On the basis of this, rank sum ratio method and TOPSIS method were used to evaluate. Results: Under the three management modes, there are some differences in the payment methods which have the best effect on outpatient and inpatient medical expenses control. Conclusion: The best payment method for medical expense control fully takes into account the main stakeholders involved in its operation mode and its strategic interest demands, so as to realize the purpose of controlling unreasonable increase of medical expenses of NCMS.