中国全科医学2017，Vol.20Issue(31)：3870-3875,6.DOI:10.3969/j.issn.1007-9572.2017.31.008
甘肃省新农合分级诊疗实施现状研究
Implementation Status of Hierarchical Medical System of New Rural Cooperative Medical System in Gansu Province
摘要
Abstract
Objective To explore the implementation status about hierarchical medical system of new rural cooperative medical system in Gansu Province,so as to put forward policy recommendations for the improvement of this system.Methods In March 2016,information about health resources allocation,medical service utilization,medical service efficiency,medical service fee in medical institutions at all levels and primary medical institutions' transfer treatment during 2014 to 2015 were collected from the National Healthcare and Family Planning Statistical Information Direct Reporting Network,and the data about the expense and beneficiaries of new rural cooperative medical funding in Gansu Province from 2014 to 2015 were obtained from the Gansu New Rural Cooperative Medical System Management Center.Results Compared with 2014,in Gansu Province in 2015,the outpatient visits in all the medical institutions,tertiary hospitals,county-level hospitals,community health service centers (stations) and village clinics increased by 7.56％,7.18％,8.82％,1.64％,and 0.03％,respectively,but they decreased by 0.90％ for township health centers;the number of discharges in all the medical institutions,tertiary hospitals,county-level hospitals,township health centers and community health service centers (stations) increased by 16.29％,2.28％,33.05％,4.19％ and 17.02％,respectively;the average bed occupancy rate in all the medical institutions,tertiary hospitals,county-level hospitals and community health service centers (stations) dropped 0.59 percentage point,1.92,1.55 and 0.64 percentage point,respectively,but in township health centers,it increased 1.08 percentage point.The average cost for each outpatient visit and the average cost for each hospitalization in Gansu Province in 2015 increased by 9.19％ and 5.91％ respectively compared with 2014.In township health centers in Gansu Province in 2015,the number of downward referrals fallen by 0.60％,but the number of upward referrals increased by 17.95％ compared with 2014.The new rural cooperative medical system pooling funds,expenditure and reimbursement times increased by 21.69％,10.71％ and 17.74％,respectively in Gansu Province in 2015 compared with 2014,specifically,the average times and amount of reimbursement for each hospitalization increased by 10.38％ and 6.83％,respectively;the amount of reimbursement for county-level hospitals increased by 14.44％.Condusion The implementation of hierarchical medical system of new rural cooperative medical system in Gansu Province has made some achievements,such as the medical service workload has been increased in tertiary hospitals and primary medical institutions,first visits and dual referrals have increased significantly in intra-county township health centers,the percentage of reimbursement from the new rural cooperative medical fund enjoyed by the patients from county-level hospitals has increased,but there are still existing problems about wasting medical resources,lacking of qualified primary medical services and inefficient sharing of medical information and so on.关键词
分级诊疗/新型农村合作医疗/实施现状/甘肃Key words
Hierarchical medical system/New rural cooperative medical system/Present situation/Gansu分类
医药卫生引用本文复制引用
杨敬宇,燕武,葛勇宏,雷丹..甘肃省新农合分级诊疗实施现状研究[J].中国全科医学,2017,20(31):3870-3875,6.基金项目
国家社会科学基金项目(13XMZ031) （13XMZ031）
