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目的:通过对新型农村合作医疗(新农合)定点医疗机构信用等级的评定,为规范新农合定点医疗机构管理提供有效方案。方法:采用第三方评价法,对江苏省27家新农合定点医疗机构进行信用等级评定,根据被评定机构相关属性分组并将评定指标进行统计学比较分析。结果:2012年较2011年定点医疗机构高信用等级有所增加;公立医疗机构、有住院部的医疗机构及综合医院信用等级相对更高,相关指标差异显著,P≤0.05。结论:信用等级偏低医疗机构存在收费混乱、医疗费用增长过快现象,医疗服务管理尚有欠缺,需要进一步完善新农合管理制度,探索更为有效的新农合支付方式,加强对民营医疗机构的监管,加强人才引进与培养,改进评定标准与方式,促进新农合制度可持续发展。
Objective: To evaluate the credit rating of new rural cooperative medical care (NCMS) designated medical institutions and provide an effective plan to regulate the management of new rural cooperative medical institutions. Methods: Third-party appraisal method was used to assess the credit rating of 27 NCMS fixed-point medical institutions in Jiangsu Province. The credit rating was assessed according to the relevant attributes of the appraised institutions and the appraisal indicators were statistically compared. Results: The high credit ratings of designated medical institutions in 2012 increased compared with those in 2011. The credit ratings of public medical institutions, medical institutions with in-hospital departments and general hospitals were relatively higher, with significant differences in relevant indicators (P≤0.05). Conclusion: There are chaotic charges and excessive growth of medical expenses in medical institutions. There is still a lack of medical service management. The management system of new rural cooperative medical institutions needs to be further improved, a more effective new rural cooperative medical payment system should be explored, Institutional supervision, to strengthen the introduction and training of qualified personnel, improve the evaluation criteria and methods to promote the sustainable development of the new rural cooperative medical system.