文章摘要
肖司懿,柴 静,沈兴蓉,程 静,王德斌.安徽省深化医改成效分析——基于食管癌患者新农合报销数据[J].南京医科大学学报(社会科学版),2020,(4):301~306
安徽省深化医改成效分析——基于食管癌患者新农合报销数据
Impact of health reforms in Anhui Province: a retrospective study of reimbursement data of esophageal cancer inpatients from the NRCMS
投稿时间:2019-10-09  
DOI:10.7655/NYDXBSS20200401
中文关键词: 食管癌  新农合  住院服务利用  基尼系数
英文关键词: esophageal cancer  NRCMS  inpatient service utilization  Gini coefficient
基金项目:国家自然科学基金“模型及人工智能引导的多肿瘤行为干预方案优化与评价”(71774002);安徽省自然科学基金“基于定量模型及在线智能的癌症筛查咨询规程优化验证”(1608085QH193)
作者单位
肖司懿 安徽医科大学卫生管理学院安徽 合肥 230032 
柴 静 安徽医科大学卫生管理学院安徽 合肥 230032 
沈兴蓉 安徽医科大学卫生管理学院安徽 合肥 230032 
程 静 安徽医科大学卫生管理学院安徽 合肥 230032 
王德斌 安徽医科大学卫生管理学院安徽 合肥 230032 
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中文摘要:
      选取安徽省2013—2017年新型农村合作医疗(简称新农合)报销系统数据,对食管癌患者的住院流向、平均住院天数、次均费用构成以及报销人次、报销费用进行统计分析。分析食管癌患者的住院服务利用及负担情况,探究安徽省新农合对食管癌报销水平的影响。结果显示,2017年安徽省每十万农村人口食管癌的新农合报销人次是2013年的20.17倍,补偿水平提高到了312 716元;患者住院费用构成中药占比、耗材占比等呈下降趋势,手术费、治疗费等呈上升趋势,医疗费用自付占比在2017年总体水平仍然高达55%;医疗总费用、补偿费用和住院天数的基尼系数处于警戒水平。食管癌医疗服务的效果、效率和公平性得到了极大提升,但要继续深化医改,采取综合措施促进形成更加合理的就诊流向,降低不公平性。
英文摘要:
      To select all the data of esophageal cancer patients in the new rural cooperative medical care system(NRCMS) in Anhui Province 2013—2017, to perform statistical analysis of the hospitalization, the average hospitalization days, the composition of the average cost, and the reimbursement and reimbursement expenses, to analyze the inpatient service utilization and burden of esophageal cancer patients,and to explore the changes in the reimbursement level of esophageal cancer. In 2017, the number of reimbursement for esophageal cancer per rural 100 000 people was 20.17 times that of 2013, and the compensation level increased to 312 716 yuan. The proportion of medical expenses and consumables fee of hospitalization expenses showed a downward trend. The surgery and treatment fees showed an upward trend, and the proportion of medical expenses paid by themselves was still as high as 55% in 2017. The Gini coefficient of total medical expenses, compensation expenses and hospitalization days are at the alert level. The effectiveness, efficiency and fairness of hospitalized medical services for esophageal cancer have been greatly improved, but we must continue to deepen medical reform and take comprehensive measures to promote a more rational flow of treatment and reduce unfairness.
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