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目的:分析新型农村合作医疗实施“按人头支付”改革对参合农民门诊就医行为的影响。方法:收集试点地区35万参合农民改革实施前、后参合农民门诊就诊的医院级别、门诊费用、补偿金额等就诊数据,并进行统计分析。结果 :支付方式改革对引导门诊人群首诊下沉、逐级转诊已显现出效果,这同时也有利于基金的收支平衡。结论:对于社区卫生服务机构门诊转诊的规范和数量控制的合理性有待进一步探讨。
Objective: To analyze the impact of the implementation of “pay by head” reform on the behavior of participating peasants clinics in new rural cooperative medical care. Methods: The data of hospital level, outpatient expenses, compensation amount and other consultation data collected before and after the implementation of the reform of 350,000 farmers participating in the pilot areas were collected and analyzed statistically. Results: The reform of the payment method led to out-patient clinic first sink, step by step referral has shown an effect, which is also conducive to the Fund’s balance of payments. Conclusion: The rationality and quantity control of outpatient referral for community health service institutions need to be further explored.