河南省医疗服务供方支付制度改革试点满意度分析

孙杨; 赵要军; 张敏; 谢双保; 吴建; 孟庆跃

引用本文：孙杨,赵要军,张敏,等.河南省医疗服务供方支付制度改革试点满意度分析[J].中国卫生政策研究,2013,6(3):31-37

河南省医疗服务供方支付制度改革试点满意度分析

投稿时间：2012-10-13 修订日期：2013-02-22 PDF全文浏览 HTML全文浏览

1.北京大学中国卫生发展研究中心;2.华中科技大学同济医学院医药卫生管理学院;3.河南省卫生厅;4.郑州大学公共卫生学院

摘要:目的：分析河南供方支付制度改革试点地区各方满意度和原因，为其它地区的改革实践提供借鉴。方法：主要采用定性访谈的方法，并通过问卷调查患者、医护人员、医疗机构管理者以及新农合经办机构的满意度。结果：患者对就医便利性和费用情况满意度较高，对医患沟通增加的感受明显，但对医疗质量的改善缺乏直观感受；医护人员对新支付方式下的结余分配机制普遍表示满意，但认为其带来的收入增加尚未达到预期；医疗机构管理者和新农合经办机构对改革带来的发展、管理和运行环境的改善表示满意。结论：河南省的改革实践实现了各利益相关方的相容，现阶段各方对改革所产生的影响均初步满意。重视并尊重供方的利益是河南实践的可借鉴之处，其增强了供方对改革的依从性和满意度。建议持续跟踪供方激励效果，同时关注服务质量的变化以保障各方的持续满意与改革的有效推进。

关键词:新型农村合作医疗支付制度改革满意度

基金项目:世界银行贷款/英国政府赠款中国农村卫生发展项目（卫XI HN ZX 2011 4）

Satisfaction analysis for pilot practice of medical services provider payment reform in Henan Province

Abstract:Objective: To assess the pilot of Henan provider payment system reform in the satisfaction of all parties and analyze the reasons and significance. Methods: The study mainly used qualitative interviews supplemented by questionnaire to survey the satisfaction of reform parties, including patients, health care workers, hospital managers, and the New Rural Cooperative Medical Scheme (NRCMS) handling agencies. Results: The patient paid high degree satisfaction to convenience and expenditure of medical treatment, and increase experience of doctor patient communication, but the lack of an intuitive feel for the improvement of the quality of medical service; health care workers are generally satisfied with the profits distribution mechanism under the new payment, but have not yet reached their expected revenue increase; hospital managers and NRCMS agencies expressed satisfaction with the improvement of the development, management and operating environment brought by the reform. Conclusion: The practice of Henan Province achieves the incentive compatibility of the various stakeholders, and get initial satisfaction of them. To value and respect the interests of provider has reference for other reform regions, and it enhances compliance and satisfaction of provider. Henan need to keep track of the incentive effects of provider, and concerned about the changes in the quality of service in order to safeguard the continued satisfaction of all parties and the effective progress of the reform.

Key words:New Rural Cooperative Medical Scheme Payment system reform Satisfaction

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