结合北京市大兴区新型农村合作医疗工作实践,从给付水平、给付种类两个方面考察了该区2005年调整给付结构政策后,合作医疗资金使用和农民就医情况的变动。通过比较研究,本文认为在经济发达地区,新型农村合作医疗适宜采取“保大病住院,适当兼顾门诊报销”的模式,并可以通过经济杠杆引导农民合理就医,以提高合作医疗资金使用效率,使该制度获得可持续发展。 Based on the practice of the new rural cooperative medical service in Daxing District of Beijing, the changes in the use of cooperative medical funds and the situation of farmers’ medical care after the adjustment of payment structure policies in 2005 were examined in terms of benefits and types of payment. Through comparative research, this paper believes that in the economically developed areas, the new rural cooperative medical care system is suitable for adopting the model of “hospitalizing hospitals with great care and appropriately taking into account outpatient reimbursement”, and can guide farmers to seek reasonable medical treatment through economic levers, so as to improve the efficiency of the use of cooperative medical funds. The system has achieved sustainable development.