【摘要】：近年來(lái),國(guó)家極其重視整改醫(yī)療保障制度,加大公共投入,加快推進(jìn)新型農(nóng)村合作醫(yī)療(以下簡(jiǎn)稱“新農(nóng)合”)和城鎮(zhèn)居民醫(yī)療保險(xiǎn)(以下簡(jiǎn)稱“城居保”)的建設(shè),迅速擴(kuò)大醫(yī)保覆蓋面范圍,緩解城鄉(xiāng)居民就醫(yī)困難,費(fèi)用高昂的問(wèn)題。但是城鄉(xiāng)二元結(jié)構(gòu)的存在,致使我國(guó)城鄉(xiāng)醫(yī)保制度分立現(xiàn)象日益明顯,從而致使其失衡。伴隨經(jīng)濟(jì)社會(huì)的不斷發(fā)展,多種醫(yī)療保險(xiǎn)并行的制度不能滿足參保人員的需求。因此,黨中央明確提出全面籌劃城鄉(xiāng)社會(huì)保障體系建設(shè)。同時(shí),新醫(yī)改方案確立了“覆蓋全民、全民醫(yī)�！钡闹匾繕�(biāo)和任務(wù)。然而,仍有部分專家表示,結(jié)合目前實(shí)際國(guó)情可知,實(shí)現(xiàn)城鄉(xiāng)醫(yī)保一體化是一個(gè)長(zhǎng)期循序漸進(jìn)的過(guò)程,操之過(guò)急反而會(huì)適得其反。各地區(qū)在經(jīng)濟(jì)狀況、人均收入、就醫(yī)觀念、制度干預(yù)等諸多方面存在的差異導(dǎo)致城鄉(xiāng)居民基本醫(yī)療保險(xiǎn)(以下簡(jiǎn)稱“城鄉(xiāng)居民醫(yī)保”)在各地推行的模式、實(shí)施方案也不同。因此,至今仍未有一個(gè)完整的評(píng)價(jià)指標(biāo)體系。但是,科學(xué)合理評(píng)價(jià)棗莊市城鄉(xiāng)居民醫(yī)保的運(yùn)行狀況,提高運(yùn)行質(zhì)量,促進(jìn)該制度健康持續(xù)發(fā)展的前提,必須是構(gòu)建一套關(guān)于該制度運(yùn)行效果的評(píng)價(jià)指標(biāo)體系。本篇論文采用理論與實(shí)證分析相結(jié)合的方法,第一,簡(jiǎn)述了城鄉(xiāng)居民醫(yī)保的相關(guān)概念和理論,分析了棗莊市2010年-2014年新農(nóng)合的基本情況;第二,對(duì)棗莊市城鄉(xiāng)居民醫(yī)保的運(yùn)行現(xiàn)狀進(jìn)行總體評(píng)價(jià)。在此基礎(chǔ)上,運(yùn)用變異系數(shù)法和聚類分析法以及專家咨詢法,設(shè)計(jì)出一套城鄉(xiāng)居民醫(yī)保運(yùn)行效果評(píng)價(jià)指標(biāo)體系。然后,運(yùn)用主成分分析法,對(duì)棗莊市5區(qū)1市城鄉(xiāng)居民醫(yī)保的運(yùn)行效果進(jìn)行綜合評(píng)價(jià),根據(jù)2個(gè)主成分綜合得分發(fā)現(xiàn),滕州市與市中區(qū)的運(yùn)行效果較好,滕州市得分最高,市中區(qū)的綜合得分為正值,嶧城區(qū)、山亭區(qū)、臺(tái)兒莊區(qū)、薛城區(qū)的綜合得分依次遞減,且均為負(fù)值,綜合得分與運(yùn)行效果成正比,因此這四個(gè)區(qū)的運(yùn)行效果在全市排名相對(duì)落后。最后,根據(jù)評(píng)價(jià)結(jié)果對(duì)進(jìn)一步完善該制度給出建議。
[Abstract]:In recent years, the state has attached great importance to rectifying and reforming the medical security system, increasing public investment, and speeding up the construction of the new rural cooperative medical care system (hereinafter referred to as "new rural cooperative medical system") and the medical insurance for urban residents (hereinafter referred to as "urban housing insurance"). Rapidly expand the coverage of health insurance, ease the difficulties of urban and rural residents access to health care, expensive problems. However, the existence of urban-rural dual structure makes the phenomenon of urban and rural medical insurance system more and more obvious, which leads to its imbalance. With the development of economy and society, the concurrent medical insurance system can not meet the needs of the insured. Therefore, the Party Central Committee clearly put forward a comprehensive plan for urban and rural social security system construction. At the same time, the new medical reform program has established the important goal and task of "covering the whole people, universal health insurance". However, some experts still say, combined with the actual situation, the realization of urban and rural health care integration is a long-term gradual process, too soon will be counterproductive. The differences in economic status, per capita income, medical concept and system intervention in different regions lead to different modes and implementation schemes of basic medical insurance for urban and rural residents (hereinafter referred to as "medical insurance for urban and rural residents"). So far, there is not a complete evaluation index system. However, a scientific and reasonable evaluation of the operation of urban and rural residents in Zaozhuang City, improving the quality of operation, and promoting the healthy and sustainable development of the system must be a set of evaluation index system about the operating effect of the system. This paper adopts the method of combining theory with empirical analysis. Firstly, it briefly introduces the related concepts and theories of urban and rural residents' medical insurance, and analyzes the basic situation of the new rural cooperation in Zaozhuang City from 2010 to 2014. Second, the operation of urban and rural residents in Zaozhuang City health insurance status of the overall evaluation. On this basis, using variation coefficient method, cluster analysis method and expert consultation method, a set of evaluation index system of urban and rural residents' health insurance operation effect is designed. Then, by using principal component analysis method, the operation effect of medical insurance for urban and rural residents in 5 districts and 1 city of Zaozhuang City is comprehensively evaluated. According to the comprehensive scores of the two principal components, it is found that the operation effect of Tengzhou City and Shizhong District is better, the score of Tengzhou City is the highest. The comprehensive scores of Shizhong District are positive, Yicheng District, Shanting District, Taierzhuang District and Xue Cheng District are decreasing in turn, and all of them are negative. The comprehensive score is in direct proportion to the effect of operation. As a result, the operation of the four districts in the city ranked relatively backward. Finally, according to the evaluation results, some suggestions are given to further improve the system.
【學(xué)位授予單位】：安徽農(nóng)業(yè)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：F842.684

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