河北省县域新农合存在的问题及对策研究.docxVIP

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摘要

新型农村合作医疗制度是专门为农民医疗需求建立的社会保险制度，有利于解决城乡发展不平衡的问题。新农合医疗保险通过医疗费用报销可以有效缓解农民的一些看病难题。而目前，新型农村合作医疗中出现了参保率下降的问题，造成这个问题的原因主要有基层医疗卫生设施配置较差，人才匮乏；筹资渠道单一，缴费连年上涨；新农合报销目录较少，农村定点医疗机构较少；医保的报销制度不合理，监管难度大。本文以邯郸市为例,从医保费用、报销目录、医保基金使用等方面进行了分析和研究，提出有针对性的建议,促进我国新农合制度的健康可持续发展。本文提出了一些建议：提高基层医护工作者的专业素质；提高农民收入，推动城乡医疗资源共享；建设基层专业化医疗机构；合理简化优化报销手续，完善医保基金的监督机制，扩大医保目录、提高对新农合的财政扶持力度等相关的政策性意见和建议。

关键词：新型农村合作医疗；医保基金；医疗设施

Abstract

Thenewruralcooperativemedicalsystemisasocialinsurancesystemspecificallyestablishedforthemedicalneedsoffarmers,whichisconducivetosolvingtheproblemofimbalancedurban-ruraldevelopment.TheNewRuralCooperativeMedicalInsurancecaneffectivelyalleviatesomeofthemedicaldifficultiesfacedbyfarmersthroughreimbursementofmedicalexpenses.Atpresent,thereisadecreaseintheparticipationrateinthenewruralcooperativemedicalsystem,whichismainlyduetopoorallocationofgrassrootsmedicalandhealthfacilitiesandashortageoftalents;Thefundingchannelissingle,andthepaymenthasbeenincreasingyearbyyear;TherearefewerreimbursementcatalogsfortheNewRuralCooperativeMedicalSchemeandfewerdesignatedmedicalinstitutionsinruralareas;Thereimbursementsystemformedicalinsuranceisunreasonableanddifficulttoregulate.ThisarticletakesHandanCityasanexampletoanalyzeandstudymedicalinsuranceexpenses,reimbursementcatalogs,andtheuseofmedicalinsurancefunds.TargetedsuggestionsareproposedtopromotethehealthyandsustainabledevelopmentofChinasnewruralcooperativemedicalsystem.Thisarticleproposessomesuggestions:toimprovetheprofessionalqualityofgrassrootsmedicalworkers;Increasefarmersincomeandpromotethesharingofmedicalresourcesbetweenurbanandruralareas;Buildingspecializedmedicalinstitutionsatthegrassrootslevel;Reasonablesimplificationandoptimizationofreimbursementprocedures,improvementofthesupervisionmechanismof