| BackgroundThe New Rural Cooperative Medical Scheme(NCMS)is the main medical insurance in current rural China, its for improving rural areas of medical condition, to improve farmers' health level and ensure farmers obtain basic medical services.reduce the economic burden of fanners medicine doctor. easing the sickness poor, poverty due to illness plays an important role in such relieves farmers difficulties in getting and doctor expensive problem, reduced the farmers medical-seeking pressure. But in the new farming the actual operation process encountered many problems to obstruct the NCMS. especially in the development of overall reimbursement model. Because of our country's NCMS plan as a whole limits larger (usually county), social,economy and culture differences across various factors determine the present new farming medical compensation mode diversity. Displays in reimbursement of problems are:many of the county (city) in implementing new farm, for reimbursement scheme microroughness unreasonable, making up too high, and paying line set top line and lower proportion of small, compensation, compensation range is narrower, largely reduced the reimbursement ginseng adds up to farmer horizontal and benefited range. In the long run. will weaken the farmers'attraction of the NCMS. influent the NCMS sustainable development.Research what overall reimbursement scheme, or overall reimbursement scheme how to steadily adjustment, make its new farming fund in ensuring safe operation, improve fund under the premise of efficiency, gradually expand the farmers' benefited range, the greatest degree of satisfaction of peasants needs of medical treatment, is we urgently need to solve the problem. So it is necessary to collect all kinds of existing overall reimbursement plan research evidence to the existing overall compensation plan make system parts were briefly reviewed, and the new rural cooperative medical overall reimbursement schemes are analyzed, existing problems, and puts forward the corresponding policy recommendations for policymakers, thus providing high quality decision-making basis.Objectives1.Collection about the NCMS reimbursement plan (reimbursemen mode, cost sharing ration.limit lin, reimbursemen proportion) with analysis evaluation.2.To all sorts of overall pattern carries on the analysis comparison, to identify the most suitable for China's new farming and continuous development of compensation mode.3. For every kind of compensation schemes system analysis and evaluation, this paper discusses the most appropriate compensation scheme, the most scientific structure proportion.4. Puts forward new farming sustainable development Suggestions for decision-making agency to develop new farming overall compensation scheme provides evidence-based basis.5.In some provinces of the new rural cooperative medical overall compensation plan operational status analysis, discusses the existing problems and puts forward relevant policy SuggestionsMethods1. Systematic ReviewThis research method is to consult the Cochrane center about system review methods and standards, first of all. according to the principle of PICO formulated according to retrieval strategy formulated, then the were included in the exclusion standard retrieval literature, collect about new farming overall compensation plan (as a whole mode, undulating lines, compensation scale, a top line, compensation range of related literatures.) Will be included in the literature quality evaluation, analysis, and extracted one important information, finally to literature analysis, and then be integrated, draw the conclusion and puts forward some Suggestions.2. descriptive analysisThe second part of zhis study, through the network search some provinces of 2010 the reimbursement plan of NCMS, descriptive analysis the operational status of the reimbursement plan, points out the existing problems and puts forward some corresponding Suggestions.Results1. The study on reimbursement plan of NCMSFinally we include 67 articles,59 of the which are Oinvestigation and study status in2003 to 2010, for such research In current research covers most of the region, there are 17 articles mainly studies the reimbursement modle; 31 references to the cost sharing ration of medical treatment of new-style country collaboration line. compensation scale, the limit line alone or comprehensive research, from their role, set mode, set sizes, the influence of set unreasonable were expounded; 19 references discussed the NCMS reimbursement range of basic drugs directory, the Chinese medicine compensation and chronic compensation for its operation, and the situation and existing problems of the research and analysis. According to the research evidence of various overall pattern we carries on the analysis comparison, points out that hospital as a whole will be new farming development direction:Points out how to setting up reasonable the cost sharing ration, compensation proportion and limit line can maximum degree of improving farmers'benefit levels:Points out that we should reasonable establishing basic drugs, improve the directory, regulating the TCM compensation proportion, expand chronic compensation ginseng adds up to farmers' benefited range. 2. The new rural cooperative medical overall compensation plan operation condition analysisThis section research and analysis the reimbursement modle of some provinces, and the overall pattern of these provinces hospital compensation scheme and outpatient service compensation plan of the cost sharing ration, limit line, compensation proportion, chronic compensation the correlation analysis, discusses the problems in the operation of the compensation plan problems and puts forward relevant policy Suggestions.Conclusions and Suggestions1. The study on reimbursement plan of NCMSThis section studied the new rural medical cooperative running three compensation mode, namely the poverty-stricken population overall outpatient, hospital, hospital as a whole with overall to add family account, three kinds of compensation mode are analyzed and compared, analysis and comparison results show that:the hospital as a whole will be added outpatient service as a whole new farming the development direction. Hospital compensation thread arrangement should press rolling with trapezoid mode set the increased level of medical institutions, start to pay increase the size usually should line of medical institution of average outpatient fee 2.0 to 3.0 times better; Outpatient service compensation generally do not set ups and downs line. Compensation according to the set than medical institution shall be different sets of different compensation levels than, than with medical institutions shall compensate the increased level of decreased and the medical institutions shall be widened the gap between the reasonable divergence patients, grading stratification; Top line Settings should according to local economic development level and funding level and decide, in principle of local per capita net income of farmers not less than 6 times of the following. Try to expand sphere of compensation, improve the compensation of traditional Chinese medicine, regulating the chronic compensation, proportion of species, expand chronic compensation reasonable set ups and downs line, a top line and compensation than, expand ginseng adds up to farmer benefited range.2. The study on operationl status of NCMSThis section study proposed to science formulation reimbursement scheme. rationally divided fund allocation proportion, setting up reasonable cost sharing ration. limit line, reimbursement proportion; Standard chronic compensation, strengthen construction of basic-level medical institutions. |
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