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目的了解玉溪市农村居民疾病直接经济负担情况,为提高新农合政策保障水平、最大限度减轻农村居民疾病直接经济负担提供参考。方法收集玉溪市2005—2012年新农合329 636例住院病例资料信息,用SPSS17.0软件进行统计分析。结果玉溪市329 636例新农合报销的住院直接经济负担平均1 819.7元/例。在医疗机构上:中位人均直接经济负担由大到小排列分别为:省级,市级、民营、县级、乡镇级;中位人均补偿比为49.1%,补偿比从大到小分别为:乡镇级医疗机构、民营、县级、市级、省级,经济负担和补偿情况排名在医疗机构上基本呈反向分布。在不同疾病类型上:中位人均直接经济负担从大到小排名为:恶性肿瘤、脑血管病、内分泌营养和代谢病、损伤及中毒、神经系病、心脏病、消化系病、呼吸系病、传染病及其他。不同疾病就诊农村居民住院直接经济负担补偿中,中位补偿比从小到大分别为恶性肿瘤、泌尿生殖系病、损伤及中毒、传染病、神经系病、内分泌营养和代谢病、呼吸系病、脑血管病、心脏病及其他。结论新农合在一定程度上降低了农村居民疾病直接经济负担,在有限的卫生资源条件下,对不同级别医疗机构及不同疾病的补偿应该综合考虑,探索更加合理的补偿制度。
Objective To understand the direct economic burden of disease among rural residents in Yuxi City and provide references for improving the level of social security policy and minimizing the direct economic burden of rural residents. Methods The data of 329 636 inpatients in NRCMS from 2005 to 2012 in Yuxi city were collected and analyzed by SPSS17.0 software. Results The direct economic burden of 329 636 NCMS reimbursements in Yuxi City was 1819.7 yuan / case on average. In the medical institutions: the median direct economic burden per capita were arranged in descending order: provincial, municipal, private, county, township level; the median per capita compensation rate was 49.1%, the compensation ratio from largest to smallest were : The rank of township medical institutions, private-owned, county-level, city-level and provincial-level, economic burdens and compensation are basically inverted in the medical institutions. In different types of diseases: the median direct financial burden per capita ranked from: cancer, cerebrovascular disease, endocrine nutrition and metabolic diseases, injuries and poisoning, neurological diseases, heart disease, digestive diseases, respiratory diseases , Infectious diseases and others. In the direct economic burden of hospitalization of rural residents with different diseases, the median compensation rates are malignant tumors, urogenital diseases, injuries and poisonings, infectious diseases, neurological diseases, endocrine nutrition and metabolic diseases, respiratory diseases, Cerebrovascular disease, heart disease and others. Conclusion NCMS to some extent reduce the direct economic burden on rural residents disease, under the conditions of limited health resources, compensation for different levels of medical institutions and different diseases should be taken into account to explore a more reasonable compensation system.