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目的比较不同级别医院参加城镇居民医疗保险(简称“参保”)和新型农村合作医疗(简称“参合”)的居民患者住院医疗费用及不同支付方式费用差别,了解城乡居民医疗保障水平。方法选择某县2011年度城乡参保和参合居民患者,运用非参秩和检验分析住院医疗费用及不同支付方式费用。结果除一般检查费外,县级医院总费用、各项费用及不同支付费用均高于乡镇医院(P<0.05);县级医院参合与参保患者平均住院费用未见有显著差异(P>0.05),但参保患者统筹支付费用高于参合患者,个人支付费用低于参合患者(P<0.05);参保及参合居民患者乡镇医院统筹支付费用及个人支付费用均低于县级医院(P<0.05),但参保居民不同级别医院间统筹支付费用(63%~64%)及个人支付费用(35%~36%)所占比例接近,参合居民个人支付费用县级医院(1 647.47元)占总费用的55.84%,乡镇医院(560.81元)占43.01%。结论促进和引导参合和参保居民患者在基层医疗机构就医、合理控制药物使用、不断提高统筹支付报销比例,以减轻城乡居民疾病经济负担。
Objectives To compare the cost of hospitalization and residents of different levels in participating in the medical insurance for residents of urban residents (referred to as “insured ”) and the new rural cooperative medical care (referred to as “participation ”) Level. Methods Select the 2011 urban and rural residents and participating residents in a county, using non-parametric rank sum test to analyze hospitalization expenses and different payment methods. Results In addition to the general examination fees, the county hospital total cost, various expenses and different payment costs were higher than that of township hospitals (P <0.05); There was no significant difference in average hospitalization expenses between county hospitals and insured patients (P> 0.05). However, the co-payment expenses of insured patients were higher than those of co-patients, and the individual payment costs were lower than those of co-patients (P <0.05). The co-ordinated payment and individual payment of insured and participating residents were lower than that of county hospitals (63% -64%) and individual payment (35% -36%) of hospitals at different levels of insured residents accounted for a similar proportion, with participation of individual residents in county-level hospitals (1 647.47 Yuan) accounted for 55.84% of the total cost, township hospitals (560.81 yuan) accounted for 43.01%. Conclusions Promote and guide the participation and participation of residents in the grass-roots medical institutions for medical treatment, rational control of drug use, and continuously improve the overall payment of reimbursement ratio in order to reduce the economic burden of urban and rural residents disease.