新型农村合作医疗卫生政策对农村卫生费用的影响研究

发布时间：2019-02-14 09:56

【摘要】：目的探讨新型农村合作医疗(新农合)卫生政策对农村卫生费用的影响,为新农合卫生政策的稳步推进提供建议。方法收集卫生总费用、农村卫生费用、农村人均卫生总费用、参合率、村卫生室数、乡村医生和卫生员数、需住院而未住院比例、农民人均医疗保健支出及占比、农民个人现金卫生支出及占比等指标数据,通过比较新农合卫生政策实施前后农村卫生费用的变化,探讨新农合卫生政策对农村卫生费用的影响。结果农村卫生费用从2001年的2 248.70亿元增至2013年的11 026.97亿元,增加8 778.27亿元,增幅为390.37%。农村人均卫生总费用从2001年的246.49元增至2013年的1 717.01元,增加1 470.52元,增幅为596.58%。参合率在2004年为75.2%,2014年为98.9%,增幅为31.52%,参合率稳步提高。乡镇卫生院的病床使用率由2003年的36.2%增加到2014年的60.5%,增幅为67.13%。农村需住院而未住院比例由2003年的30.3%下降至2013年的16.7%,下降了13.6个百分点。农村居民的人均医疗保健支出由2001年的96.61元增加至2014年的753.90元,增加了657.29元,增幅为680.35%,占人均纯收入比例、占人均生活消费支出比例也呈增高趋势。农村居民的个人现金卫生支出由2001年的1 491.60亿元增加至2014年的3 883.90亿元,增幅为160.38%;而个人现金卫生支出占卫生总费用的比例由2001年的29.68%下降至2014年的11.00%,下降了18.68个百分点。结论新农合卫生政策的实施造成农村卫生费用上升,农村的人均卫生总费用、参合率、人均医疗保健支出大幅增加,需住院而未住院的比例、个人现金卫生支出占比明显下降。新农合卫生政策的落实,需要卫生费用的大力支持,国家需提供更多的医疗补助,加大宏观层面的卫生费用投入,降低微观个体的医疗负担。应继续着力推进新农合卫生政策,提高卫生服务的公平性。
[Abstract]:Objective to explore the impact of the new rural cooperative medical policy on rural health costs and provide suggestions for the steady progress of the new rural cooperative medical policy. Methods the total health expenditure, rural per capita health expenditure, participation rate, the number of village clinics, the number of village doctors and health workers, the proportion of rural doctors and health workers who needed hospitalization and the proportion of rural health care expenditure per capita were collected. By comparing the changes of rural health expenditure before and after the implementation of the new rural cooperative health policy, the impact of the new rural cooperative health policy on rural health expenditure was discussed. Results the rural health expenditure increased from 224.87 billion yuan in 2001 to 1.102697 trillion yuan in 2013, an increase of 877.827 billion yuan, an increase of 390.37 yuan. The total per capita health expenditure in rural areas increased from 246.49 yuan in 2001 to 1 717.01 yuan in 2013, an increase of 1 470.52 yuan, or 596.58 yuan. The participation rate was 75.2 in 2004 and 98.9 in 2014, with an increase of 31.52and a steady increase. The utilization rate of hospital beds in township hospitals increased from 36.2% in 2003 to 60.5% in 2014, an increase of 67.13%. The proportion of rural residents who were hospitalized but not hospitalized fell 13.6 percentage points from 30.3 percent in 2003 to 16.7 percent in 2013. The per capita medical and health care expenditure of rural residents increased from 96.61 yuan in 2001 to 753.90 yuan in 2014, an increase of 657.29 yuan, an increase of 680.35 yuan, which accounted for the proportion of per capita net income and the proportion of per capita living consumption expenditure. The personal cash health expenditure of rural residents increased from 149.16 billion yuan in 2001 to 388.39 billion yuan in 2014, an increase of 160.38 yuan. Personal cash spending on health fell 18.68 percentage points from 29.68 percent in 2001 to 11.00 in 2014. Conclusion the implementation of the new rural cooperative health policy resulted in the increase of rural health costs, the total health expenditure per capita, the participation rate, the per capita health care expenditure, the proportion of medical care expenditure in hospital but not in hospital, and the proportion of personal cash health expenditure decreased significantly. The implementation of the new rural cooperative health policy needs the support of health expenditure, the state needs to provide more medical aid, increase the macro level of health expenditure investment, and reduce the medical burden of micro individuals. We should continue to push forward the new rural health policy and improve the fairness of health services.
【作者单位】：江西科技师范大学经济管理学院;华中科技大学同济医学院;
【基金】：国家自然科学基金资助项目(71473110) 中国博士后特别资助基金项目(2015T80811)
【分类号】：F323.89;F842.684;R197.1

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