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目的:总结吉林省新型农村合作医疗制度经验,分析实行“住院低比例报销起付段”对住院率的影响,为全国新型农村合作医疗制度有效运行提供参考和借鉴。方法:采用分层抽样方法抽取13个样本县,对省、县、乡三级医疗卫生机构进行现场调查和数据搜集。结果:新型农村合作医疗门诊统筹与住院低比例报销起付段的结合,有效抑制了住院率的增长,合理调整了县乡两级医疗机构的就医结构,适度规避了“门诊转住院”风险。结论:住院低比例报销起付段新举措的实施具有积极意义,但在推广的过程中也应注意因地制宜和基金风险。
OBJECTIVE: To summarize the experience of the new rural cooperative medical system in Jilin Province and to analyze the impact of the “hospitalization with a low proportion of reimbursement starting from hospitalization” on the hospitalization rate, so as to provide reference and reference for the effective operation of the new rural cooperative medical system across the country. Methods: Thirteen sample counties were selected by stratified sampling method, and field investigation and data collection were carried out on the provincial, county and township level medical and health institutions. Results: The combination of new rural cooperative medical outpatient co-ordination and low proportion of hospital reimbursement starting-up period effectively restrained the growth of hospitalization rate, rationally adjusted the medical treatment structure of medical institutions at county and township levels, and moderated the “outpatient hospitalization” risk. CONCLUSION: The implementation of the new measures for starting a hospital with a low proportion of reimbursement in hospital has positive significance. However, in the process of popularization, the risks of the fund should be adjusted according to the local conditions and the fund.