新型农村合作医疗发展问题研究

—— 以济南为例
Research on New Style Village Cooperation Medical Treatment Problem Basing on Equity

作者: 专业:农业推广 导师:胡继连 年度:2009 学位:硕士  院校: 山东农业大学

Keywords

new style village cooperation medical treatment, equity, problem resaerch, development strategy

        长期以来,我国城乡居民在收入水平、卫生资源配置及社会保障等方面存在着明显差距。由于农民没有享受基本医疗保险待遇,抵抗大病风险的能力很弱,农民看病难、看病贵问题始终得不到有效解决,因病致贫、因病返贫现象普遍存在。基于相对公平环境下,全面实施新型农村合作医疗,通过政府引导资助,广大农民共同参与,建立起“风险共担,互助共济”的新型农村合作医疗体系,才能使农民因病致贫、返贫问题逐步缓解并得到有效解决。本文立足济南地区,通过借鉴国内外专家学者有关新型农村合作医疗问题研究的理论和经验,以及对济南新农合制度试点的总体评价、取得绩效及在试行过程中存在的问题及挑战,采用理论分析、实证研究、案例分析等方法,多层次、多学科角度地对研究对象进行论证和研究。当前,济南新农合制度存在管理机制不健全、基金管理不规范、定点医疗机构管理不完善、实施过程中存在诸多制度缺陷等问题。其问题的症结在于:一,政府干预极为有限;二,制度设计有待完善;三,农村卫生资源配置不公平、不均衡;四,农民理解力、收入水平等多重因素共同制约参合;五,医药市场监管力度不足;六,缺乏统一、规范、高效的监管机制等。据此,本文提出完善新型农村合作医疗制度的对策建议,主要包括:农民、定点医疗机构、新农合管理者三大主体应积极配合、相互协调,促进新农合的发展;优化新农合方案设计;完善新农合内部环境;创造有利的新农合外部环境等,试图系统而有针对性地对完善新型农村合作医疗制度提供实效建议。
    In china, there is great distance between urban and rural inhabitants in salary, medical resource share and social security. Because rural inhabitants do not have basic medical insurance, they are incapable to face the serious disease. There is no effective solutions for the medical treatment problem of rural inhabitant, which is difficult and expensive to see a doctor. Rural inhabitants popularly become poor bacause of disease. Basing on relatively equitable environment, fully implement new style village cooperation medical treatment,with lead and fund of government, with paticipation of all rural inhabitants, the problem of poverty bacause of disease could be solved effictively.This article basing on equity angle, have a foothold on Jinan, and benefit from the theory and experience of research of abroad scientist, and the general evaluation, achievement and effects of Jinan new style village cooperation medical treatment experimental unit, using theoreticalanalysis, empirical study and example analysis, research and prove the subject investigated in multi level and multi angle.At present, Jinan new style village cooperation medical treatment is not perfect on system, not standard on fund management, not integrated on fixed medical units management, and meet some system deficiencies during implementation. The crux of the problem is: 1. Government Intervention is limited. 2. System design need to be improved. 3. Vallige medical resource is not equitable. 4. the understand ability and salary level of rural inhabitants restrict them. 5. The medical maket lack of supervision and control. 6. lack of united, standard and efficient supervision and control system. In conclusion, this article raises the suggestion on how to make new style village cooperation medical treatment system more perfect, including: rural inhabitants, fixed medical units and administer shall cooperate actively, improve the development of new style village cooperation medical treatment system, optimize the design paln, make the inner enviornment better, creat the better external environment.etc. Try to bring effective suggestion to new style village cooperation medical treatment system well targeted.
        

新型农村合作医疗发展问题研究

摘要3-4
abstract4-5
1 引言7-17
    1.1 研究目的及意义7-9
    1.2 国内外研究文献综述9-14
    1.3 研究方法及研究路线14-15
    1.4 研究的主要内容和基本结构框架15-17
2 新型农村合作医疗的基本概念17-22
    2.1 基本概念界定17-18
    2.2 新型农村合作医疗的特点18-20
    2.3 新型农村合作医疗的基本原则20-22
3 新型农村合作医疗制度的理论基础22-31
    3.1 公共产品理论22-23
    3.2 福利经济学和社会保障理论23-25
    3.3 疾病风险与保险理论25-28
    3.4 制度经济学理论28-29
    3.5 公平理论29-31
4 农村医疗保障制度的国际比较及启示31-58
    4.1 发达国家的农村医疗保障制度31-42
    4.2 发展中国家的农村医疗保障制度42-50
    4.3 农村医疗保障制度的国际比较和启示50-58
5 新型农村合作医疗国内模式的比较分析58-74
    5.1 新型农村合作医疗国内典型模式59-67
    5.2 新型农村合作医疗典型模式评价67-74
6 济南新型农村合作医疗制度实施的案例分析74-95
    6.1 济南新型农村合作医疗制度的基本情况75-77
    6.2 济南新型农村合作医疗制度试点工作取得的绩效77-81
    6.3 济南新型农村合作医疗制度试点运行中存在的问题81-87
    6.4 新型农村合作医疗制度存在问题的原因分析87-95
7 新型农村合作医疗制度发展策略95-103
    7.1 三大主体应积极配合、相互协调,促进新农合的发展95-97
    7.2 优化新农合方案设计97-98
    7.3 完善新农合内部环境98-102
    7.4 创造有利的新农合外部环境102-103
8 存在的不足103-105
参考文献105-109
致谢109
        下载全文需10


本文地址:

上一篇:泰安市农村信息服务平台建设研究
下一篇:潍坊市农业剩余劳动力转移的影响因素与对策研究

分享到: 分享新型农村合作医疗发展问题研究到腾讯微博           收藏
评论排行
公告