大病统筹

建立农村大病统筹医疗保险模式的可行性分析

A Feasibility Analysis on Constituting the Major-medical mode of Plan as A Whole in Rural Areas

以大病统筹方法解决农村居民因病致贫的可行性研究

Feasibility Study On Resolving the Poverty Caused by Illnesses of Agrarian Population Through the Scheme Pooling funds for Serious Illnesses

结果复印病案办理大病统筹的数量占第一位，其次为报销凭证、司法鉴定和保险理赔等。

Results The major purpose of copying the medical records was for health insurance covering major cases of illness , and others were expert evidence and compensation of medical insure .

本研究的主要目的是为把农村居民慢性病门诊费用纳入大病统筹提供可行性的政策方案和方法。农村居民慢性病门诊费用纳入大病统筹的可行性研究

The main object of this study is to put forward feasible Feasibility Study on Taking Outpatient Fee of Chronic Diseases of Rural Residents into " Pooling Funds for Serious Illnesses "

需方医疗费用补偿公平性：①3个样本县新农合基金在门诊和住院之间的基金分配比例、以大病统筹为主政策的体现和需方受益存在差别。

The ratio of NCMS fund distribution between out-patient and in-patient , the embodiment of the policy mainly to catastrophe and the benefit incidence of insured peasants are different among the three sample counties .

新型农村合作医疗制度是由政府组织、引导、支持，农民自愿参加的，个人、集体和政府多方筹资，以大病统筹为主的，农民医疗互助共济制度。

The new rural cooperative medical care system is organized , guided and supported by the government , and gives farmers autonomy of participation . The funds come from individuals , collective and government .

2003年以大病统筹为主的新型农村合作医疗制度建立，减轻了参合农民就医经济负担，农民对卫生资源的利用率不断提高。

Since 2003 , the new rural cooperative medical care scheme ( NCMS ) was established , Participated farmers could reduce the financial burden of medical care , health resources utilization was continued to improve .

通过研究，主要回答以下问题：（1）是否应该把农村居民慢性病门诊费用纳入大病统筹基金？

This study aims to answer the followed questions : ( 1 ) whether outpatient fee of chronic diseases of rural residents should be taken into " pooling funds for serious illnesses " or not ?

新型农村合作医疗是由各级政府引导，农村居民参加、集体扶持、财政资助相结合，以大病统筹为主的农村居民互助共济的基本医疗制度。

The new rural cooperative medical care is the basic health system mainly for serious illness co-ordinate , which is guided by the governments at all levels , participated by rural residents , and combined with the collective support and financial assistance .

制度设计上以大病统筹为主，但可能将一部分参合农户拒之门外，起付线过高或补偿比过低也会降低农户的实际收益。

Maybe some rural households are rejected owing to " major co-ordination " is the main forms of the New Cooperative Medical Treatment System . In addition too high pay line and too low compensation will reduce the real income of rural households .

分析了目前我国医疗制度改革所面临的6个难点：1.资金筹措中投保基金数额的确定；2.大病统筹与个人帐户基金比例的划分；

The article discusses difficulties and solutions in medical administration reforms on these six aspects : 1 . quota of insurance proceeds in fund raising , 2 . overall planning on ratio between medical expenses of serious diseases and the money amount in the individual account .

这对如何通盘考虑门诊大病和普通门诊统筹两项制度安排，妥善解决参保人员的门诊费用，使有限的医疗保险基金得到有效利用提出了要求。

This is how to take into consideration the serious illness and general out-patient clinic of the two systems co-ordination arrangements , properly solve the out-patient insured costs , so that the limited medical insurance fund has been set forth requirements for effective use .