甘肃省新农合分级诊疗实施现状研究

发布时间：2018-02-15 08:59

  本文关键词： 分级诊疗 新型农村合作医疗 实施现状 甘肃　出处：《中国全科医学》2017年31期 　论文类型：期刊论文

【摘要】：目的探讨甘肃省新农合分级诊疗的实施现状,为促进新农合分级诊疗制度的进一步完善提供政策建议。方法于2016年3月,通过2014—2015年国家卫生计生统计信息网络直报数据,收集各级医疗机构的卫生资源配置、医疗服务利用、医疗服务效率、医疗服务费用、基层医疗卫生机构转诊情况指标;通过2014—2015年甘肃省新型农村合作医疗管理中心数据,收集甘肃省新农合筹资补偿、资金流向指标。结果 2015年甘肃省医疗机构总门诊人次较2014年增长7.56%,三级医院、县级医院、社区卫生服务中心(站)、村卫生室分别增长7.18%、8.82%、1.64%、0.03%,乡镇卫生院下降0.90%;总出院人次较2014年增长16.29%,三级医院、县级医院、乡镇卫生院、社区卫生服务中心(站)分别增长2.28%、33.05%、4.19%、17.02%。2015年甘肃省平均病床使用率较2014年下降0.59个百分点,三级医院、县级医院、社区卫生服务中心(站)分别下降1.92、1.55、0.64个百分点,乡镇卫生院增长1.08个百分点。2015年甘肃省门诊次均医疗费用较2014年增长9.19%,次均住院费用较2014年增长5.91%。2015年乡镇卫生院接诊下转人次较2014年下降0.60%,向上转诊人次较2014年增长17.95%。2015年甘肃省新农合统筹资金、基金支出、补偿人次分别较2014年增长21.69%、10.71%、17.74%,其中住院补偿人次和补偿基金分别较2014年增长10.38%、6.83%,县级医疗机构新农合住院补偿基金较2014年增长14.44%。结论甘肃省新农合分级诊疗工作取得了一定成效,三级医院和基层医疗卫生机构的医疗服务量均有所提高,乡镇卫生院县域内首诊与双向转诊地位凸显,新农合基金县级医疗机构占比有所增长,但依然存在医疗资源浪费、基层医疗卫生机构服务水平不足、医疗信息共享不畅通等问题。
[Abstract]:Objective to explore the present situation of the implementation of the new rural cooperative classification system in Gansu Province, and to provide policy suggestions for the further improvement of the new rural cooperative classification system. Methods in March 2016, the data were reported directly through the National Health and Family Planning Statistical Information Network in 2014-2015. Collect the allocation of health resources, utilization of medical services, efficiency of medical services, medical service costs, referral status indicators of primary medical and health institutions at all levels of medical institutions; through the data of the New Rural Cooperative Medical Care Management Center of Gansu Province in 2014-2015, Results in 2015, the total outpatient visits of medical institutions in Gansu Province increased by 7.566.The third level hospitals, county-level hospitals, and county-level hospitals, The number of community health service centers (stations and village clinics) increased 7.18% 8.82% 1.64% and 0.03% respectively, and the total discharge number of community health service centers decreased by 0.90%, and the total discharge number increased by 16.29% compared with 2014, third level hospitals, county-level hospitals, township hospitals, Community health service centers (stations) increased by 2.28%, 33.05% and 4.19% respectively. The average hospital bed utilization rate in Gansu Province in 2015 was 0.59% lower than that in 2014, and that in third-level hospitals, county-level hospitals, and community health service centers (stations) decreased by 1.92 卤1.55- 0.64 percentage points, respectively. In 2015, the average outpatient medical expenses in Gansu Province increased 9.19% compared with 2014, and the average hospitalization expenses increased 5.91.2015 when compared with 2014, the number of referrals in township hospitals decreased 0.60%, and the upward referrals were 0.60% lower than 2014. The increase of 17.95. 2015 in Gansu Province's new agricultural cooperation coordinated funds, Fund expenditures, Compared with 2014, the number of compensations increased by 21.69 and 10.71 respectively, in which the number of in-patient compensation and the compensation fund increased by 10.38 and 6.83 respectively compared with 2014, and the new rural cooperative hospital compensation fund at the county level increased by 14.44 compared with 2014. Conclusion the classified diagnosis and treatment of NCMS in Gansu Province has achieved certain results. The volume of medical services in tertiary hospitals and primary medical and health institutions has increased, and the status of first and two-way referral in township health centers has become prominent. The proportion of new rural cooperative fund county-level medical institutions has increased, but there is still a waste of medical resources. The level of primary health care service is insufficient, medical information sharing is not smooth and so on.
【作者单位】： 甘肃中医药大学经管学院;兰州大学公共卫生学院社会医学与卫生事业管理研究所;
【基金】：国家社会科学基金项目(13XMZ031)
【分类号】：F323.89;F842.684;R197.1
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本文编号：1512912