| 引用本文：刘双, 王芳, 田淼淼, 贾梦, 陈凯, 赵艳青, 蒋祥, 谭雯.县域医共体对新农合参合居民就诊流向的影响分析——以安徽省定远县为例[J].中国卫生政策研究,2018,11(4):45-49 |
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| 县域医共体对新农合参合居民就诊流向的影响分析——以安徽省定远县为例 |
| 投稿时间：2017-10-18 修订日期：2018-01-10 PDF全文浏览 HTML全文浏览 |
| 刘双1,2, 王芳2, 田淼淼2, 贾梦2, 陈凯3, 赵艳青1,2, 蒋祥1,2, 谭雯1,2 |
1. 北京协和医学院 北京 100730;
2. 中国医学科学院医学信息研究所 卫生体系与政策研究中心 北京 100020;
3. 国家卫生计生委基层卫生司 北京 100191 |
| 摘要:目的：分析安徽省定远县开展县域医共体建设对新农合参合居民就诊流向的影响。方法：开展访谈了解县域医共体主要改革举措，收集2015-2016年新农合平台数据及相关政策文件。结果：2015-2016年参合人员就诊流向发生改变；（1）县域外住院病人减少了3.31%；（2）县域内县乡两级医疗机构门诊、住院人次显著增加，且乡镇卫生院住院人次数增长幅度大于县级医院；村卫生室诊疗人次数下降。3）县域外诊疗费用远高于县域内，且县级医院次均费用增长明显，而乡镇卫生院基本保持不变。结论：县域医共体建设有助于减少县域外住院人次数、减轻新农合基金压力；进一步改善县域就诊流向面临人才短缺、信息化发展滞后等挑战。 |
| 关键词:县域医共体 新农合 就诊流向 |
| 基金项目:2017年国家卫生计生委基层司委托重点项目；中国医学科学院医学与健康科技创新工程项目（2016-I2M-3-018） |
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| Analysis of the impact of county medical alliance on patient flows under the NRCMS: A case study of Dingyuan county of Anhui Province |
| LIU Shuang1,2, WANG Fang2, TIAN Miao-miao2, JIA Meng2, CHEN Kai3, ZHAO Yan-qing1,2, JIANG Xiang1,2, TAN Wen1,2 |
1. Peking Union Medical College, Beijing 100730, China;
2. Institute of Medical Information, Center for Health System and Policy, Chinese Academy of Medical Sciences, Beijing 100020, China;
3. Department of Primary Health Care, National Health and Family Planning Commission, Beijing 100191, China |
| Abstract:Objective:This study is conducted to analyze the impact of county medical alliance on patient flows under the NRCMS in Dingyuan county of Anhui province. Methods:data on patient-flow were collected through the NRCMS information platform and related policy documents for 2015-2016, and interviews were conducted to study the main reform practices in the county medical alliance. Results:The patient flow under the NRCMS varied in the way of 1) the total number of inpatients seeking treatment outside of the county decreased by 3.31%; 2) the treatment volume of county-level hospitals and township health centers were increasing, and the latter one is growing faster than the former, meanwhile, the treatment volume of the village clinics declined, and 3) the hospitalization expenses per inpatient for patients who seek treatment outside the county are much higher than the expenses incurred within the county. Conclusions:the development of county-level medical alliance has influence on patients with common diseases who used to seek treatment by helping to reduce the number of inpatients outside the county and reduce the pressure of the new rural cooperative fund. However, significant problems still exist such as shortage of talented practitioners, and lagging development of information technology system. |
| Key words:County medical alliance Patient flow The New Rural Cooperative Medical Scheme (NRCMS) |
| 摘要点击次数: 1968 全文下载次数: 1034 |
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