| 摘要: |
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目的
通过分析黑龙江省乡镇卫生院住院医疗费用，进而对补偿水平进行评价并就医保政策提出建议。方法 从黑龙江省41个县域中随机抽样出3个不同经济水平的县域，对其所含各乡镇卫生院患者住院医疗费用从不同角度进行分类比较。结果 黑龙江省乡镇卫生院住院费用医保补偿比水平较高，为79.54%，其中慢性病补偿比最高，为87.80%，肿瘤和消化系统疾病补偿比较低，分别为70.01%、65.33%，低保户84.61%的补偿比较正常人员78.86%的补偿比高。结论 应当设置合理的疾病补偿结构，扩充医保福利包，优化分级诊疗制度；将重点从提高医保报销比例转移到多种医保类型的综合报销模式，改善农村居民享有医保的公平性，提高经济补偿水平。 |
| 关键词: 住院医疗费用 乡镇卫生院 自付比例 补偿 |
| DOI： |
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| Research on the Level of Inpatient Compensation from Medical Expenses with Medical Insurance in Township Health Centers of Heilongjiang Province |
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| Abstract: |
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Objective
Through the analysis of the hospitalization medical expenses of towns and townships in Heilongjiang Province, to evaluate medical compensation level and put forward suggestions on medical insurance policy. Method From the 41 county in Heilongjiang province, 3 counties of different economic levels were chosen by random sampling. Comparison of their inpatients’ medical expenses of all health clinics in towns and townships are compared from different angles. Result The level of inpatient compensation from medical expenses with medical insurance in township health centers of Heilongjiang Province is high, which is 79.54%. Chronic compensation is the highest, which is 87.80%. Compensations of digestive system disease and tumors are lower, which are 70.01% and 65.33% respectively. 84.61% of low-income residents’ compensation is higher than 78.86% of normal personnel. Conclusion Reasonable compensation structure should be set up, medicare benefits package be expended, and hierarchic system of diagnosis and treatment be perfected; pursuing high compensation should be converted into a comprehensive compensation model, fairness of grassroots residents enjoying medical insurance be improved, and the level of economic compensation be raised. |
| Key words: inpatient cost, township health center, self-paid rate, compensation |
