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目的:探讨不同地理区域、不同经济水平下的新农合的运行机制和发展方向。方法:以分层、整群抽样的方法观察450万人口范围内的新农合运行状况,统计对比当地实施新农合前后卫生服务利用程度的各项指标。结果:年住院率、两周就诊率、门诊分流构成、住院分流构成等各项卫生服务利用指标,较新农合实施前都有了明显的改善。结论:新农合的实施提高了农村居民的卫生服务利用程度,使农村居民就诊医院的层次重心下移,提高了乡镇卫生院的利用,缓解了城市大医院的压力。
Objective: To explore the operating mechanism and development direction of NCMS in different geographical regions and different economic levels. Methods: The stratified and cluster sampling method was used to observe the NCMS operating status within a population of 4.5 million and statistics were compared with those of local health services utilization before and after NCMS. Results: The annual hospitalization rate, two-week visiting rate, clinic outpatient diversion structure, hospitalization diversion composition and other indicators of utilization of health services have been significantly improved before the implementation of the new rural cooperative medical system. Conclusion: The implementation of NRCMS improved the utilization of health services of rural residents, lowered the center of gravity of hospitals visited by rural residents, improved the utilization of township hospitals and relieved the pressure of urban hospitals.