基于面板数据的新农合费用控制机制分析

基于新农合运行机制的定性分析和面板数据模型的实证研究,讨论了新农合费用快速增长的原因。研究发现,新农合医疗费用快速增长的根源在于费用控制机制在重心定位、支付方式选择、监管主体能力等方面存在先天不足;重塑新农合费用控制机制应实现控制重心由新农合经办机构向医疗服务提供方转移,支付方式由后付制向预付制、混合制转变,监管手段由依附式被动手工审核向独立化主动信息预警系统过渡,医疗机构管理模式由僵化的行政式管理向重差异重竞争的市场化管理方式演变。

On the Medical Expense Control Mechanism of New Rural Cooperative Medical:Based on Chinese Provincial and County Panel Data

The rising medical expense of new rural cooperative medical gains widely attention.We present a theoretical framework and discuss the reasons of the rising medical expense by exploring Chinese provincial and county panel data.The results show that the key point of rising medical expense of new rural cooperative medical may be some inherent shortages in the control centre,payment and capacity of supervision;rebuilding the control mechanism of medical expense should shift the control centre from government to hospitals and doctors,change the post payment mode to prospective payment system,from handwork supervision to independent information self-warning system,from rigid administrative model to market-led management.