四川省的新型农村合作医疗中的关键问题及其对策研究
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摘要
为了解决农民“因病致贫,因病返贫”的发生,2002年10月中共中央、国务院在颁布的《中共中央、国务院关于进一步加强农村卫生工作的决定》中提出了在农村建立以大病统筹为主的新型农村合作医疗制度。现阶段对于新农合运行中存在问题的研究中,都人为的将筹资补偿、卫生服务和管理模式分开,没有从整体上把握。而对于新农合中关键问题的把握也往往局限于其中的某个部分。四川省是西部地区较有代表性的农业大省,通过对于四川省新农合中关键问题的研究,有利于促进四川省农民健康水平的提高。同时也为四川省提高新农合质量提供相应的对策。本文通过文献和实证的方法,结合四川省的新农合发展现状,从整体上把握,找出其运行中存在的关键问题。通过对关键问题进行分析,提出提高新农合质量的对策。基于此,本文的具体研究思路和逻辑框架如下：
第一章绪论部分。该部分概括阐述了新农合产生的背景,发展历程以及本课题研究的意义；介绍了本文研究的内容和采用的方法；通过文献复习,综述了对新农合现阶段存在的问题的相关理论。
第二章四川省新农合现状及关键问题。本章通过四川省新农合现状的描述引出四川省新农合中存在的关键问题。总结出现阶段四川省新农合存在的关键问题主要为：四川省的筹资水平较低；在筹资水平较低的情况下,如何通过医疗服务的组织和管理来提高卫生资源使用效率；以及,如何通过付费制度的改革、管理模式的创新来提高合作医疗资金的使用效率。
第三章四川省新农合筹资水平分析。本章主要通过精算分析,采用实证的方法来说明四川省的筹资水平。该部分从三个方面来说明四川省现阶段的筹资不足：首先,选取四川省筹资水平最高的成都市温江区,以政府公布的数据做一个实证分析；其次,选择经济水平发达的成都市,经济水平中等的绵阳市和经济状况相对较差的内江市,通过实地调研数据,结合精算模型分析其筹资水平；最后通过四川省卫生厅公布的新农合运行数据分析四川省的筹资水平。通过分析可以知道,如果要使四川省的补偿水平达到50%以上,还要极大的提高现阶段的筹资水平,而由于农民有限的缴费能力,政府必须大幅提高新农合的资金补助。
第四章新农合中医疗服务提供的组织与管理。本章主要从优化资源配置,合理的利用医疗卫生资源,加大对医疗服务过程的监管三个方面来探讨。首先,通过对四川省城乡卫生资源分布现状的分析,讨论解决卫生资源分布不均衡的的方法,使农民可以获得更多的优质廉价的卫生服务。其次,双向转诊机制能够促进合理的利用卫生资源,通过对四川省现阶段双向转诊机制存在的问题分析,探讨如何完善双向转诊机制,从而通过提高卫生资源的利用效率来提高新农合基金的使用效率。最后,医疗服务过程中由于其专业性容易产生服务过程中的医疗卫生资源浪费,探讨如何通过加强对医疗服务过程的监管来提高合作医疗基金的利用效率。
第五章新农合中付费及管理模式的改革与创新。另一种有效解决新农合筹资不足问题就是改革付费制度,创新管理模式。通过将现在的医疗付费的后付制转化为预付制,可以将医疗费用风险由合作医疗保险机构控制转化为医疗机构控制,促使医疗机构主动控制医疗费用,提高合作医疗基金的使用效率。在管理模式上,在新农合中引入商业保险公司,’通过利用保险公司保险理念,对保险的专业经营和精算技术,提高新农合的运作效率和资金使用效率。本章主要通过对国内外现阶段主要付费方式的比较,给四川省新农合的付费制度改革提出建议；通过对现阶段我国其它地区的商业保险参与新农合模式的探讨,给四川省新农合管理模式的创新提出建议。
本文的创新之处主要如下：
第一,本文通过系统的分析新农合运行过程中的各个环节,较为准确全面地把握住了其中的关键问题,而不仅仅讨论某个环节中的问题。
第二,通过引入精算模型分析新农合现阶段的筹资水平,以政府公布数据和调研数据作为实证,使得本文对筹资水平不足的问题分析更加具有说服力。
第三,在筹资水平不足的条件下,本文更多的是从提高合作医疗基金利用效率上去寻找解决方案。寻找通过合理的组织和提供医疗卫生资源,革新付费体制和管理模式,使得在现有筹资水平下农民能够购买到优质廉价的卫生服务的模式。
同时,由于本文实证部分的调查数据样本有限,对于新农合中筹资补偿水平的分析可能存在一定的影响；在对于付费体制和管理模式探讨时,由于四川省缺乏相应的案例,本文仅能够借鉴国内外的一些相关经验对其做理论上的探索,在实际推广过程中可能会遇到更多的困难。在本文的撰写过程中,由于笔者的水平和精力有限,虽尽力而为,但文章之中仍难免存在着一些纰漏之处。
In order to solve the occurrence of the farmers'problem that impoverished by hospitalization, and the illness back into poverty, the New Rural Co-operative Medical Care (Referred to as NRCMC) of NRCMC established, which is based on the "CPC Central Committee and State Council on the decision of further strengthening rural health work", promulgated by in October 2002. At present, the analyses of financing, compensation, health service and management models were separated. And the grasp of key issues of the NRCMC is also limited. Sichuan Province is a major agricultural province in the western region. It is useful to promoting the improvement of health level of the farmers in Sichuan Province by the analyses of the key issues of NRCMC. Combining the actual of Sichuan Province, this paper finds the key issue of the NRCMC through the Literature Review and Empirical Methods. And it finds a way to improve the NRCRC. This paper put forward the suggestion for the healthy development of NRCMC through the research on the key issues of the NRCMC. For this reason, this specific research ideas and the logical framework are as follows:
Chapter One:Introduction. This section generalizes the background, development process as well as the researches significant of NRCMC; introduces the contents of this study and the method used; gives an overview of existing theories for the key issues of NRCMC through the literature review.
Chapter Two:The status and key issues of Sichuan Province. Through the description of NRCMC status, this chapter leads to the key issues existing in NRCMC of Sichuan Province. The mainly issues of Sichuan Province's NRCMC are:a low level of funding in Sichuan Province; in the case of low funding levels, how to improve efficiency in the use of health resources through the organization and management of medical services; and, how to improve the efficiency of cooperative medical care funds through the payment system's reform, the management's innovation.
Chapter Three:The analysis of NRCMC financing of Sichuan Province. This chapter is primarily through actuarial analysis to illustrate the funding level in Sichuan Province. That part illustrates the lack of funding at this stage in Sichuan Province from three aspects:First, selecting the highest level of funding in Wenjiang area in Chengdu city of Sichuan Province, making an empirical analysis according to the data released by the Government; Second, choosing the well-developed Chengdu, medium-developed Mianyang and relatively poor Neijiang, analyzing its funding level through field survey data and combined with the actuarial model; Finally, analyzing Sichuan Province's funding level through NRCMC working data announced by Sichuan Provincial Health Department.
Chapter Four:The organization and management provided by the medical service in NRCMC. In the case of funds' shortfall of NRCMC, in order to improve NRCMC working efficiency, one of the best way is to let medical and health institutions provide farmers with more high-quality low-cost medical health services through providing organization and management for medical service. The chapter explores optimizing the allocation of resources, rational use of medical and health resources and increase the regulation of medical service process. First of all, analyzing the distribution status of health resources in urban and rural areas in Sichuan province, discussing the ways to solve the uneven distribution of health resources in which farmers can get more high-quality low-cost health services. Second, the two-way referral mechanism can promote the rational use of health resources. Analyzing the problems in two-way referral mechanism in Sichuan Province at the present, explores how to improve two-way referral mechanism, thereby enhancing NRCMC fund's efficiency from improving efficiency in the use of health resources. Finally, due to the waste of medical health resources in the process of service for it's professional, explores how to improve the utilization efficiency of cooperative medical care funds through strengthening the supervision of the process of health care services.
Chapter Five:The reform and innovation of payment and management mode in NRCMC. Another effective solution to the problem of inadequate financing of NRCMC is to reform payment system and innovate management mode. Changing the current medical paying from post-payment into pre-payment, then the medical organizations can control the risk of medical costs from not cooperative medical insurance institutions, which prompts medical organizations to control medical costs actively and increases the efficient use of cooperative medical care funds On management model, introduced commercial insurance companies in NRCMC, improves the operational efficiency of NRCMC and financial efficiency through the use of the insurance concept, the professional management and actuarial techniques of insurance companies. This chapter gives suggestions to the payment system's reform of Sichuan Province NRCMC through comparing the mainly payment methods at home and abroad; and gives suggestions to management mode's innovation of Sichuan Province NRCMC from exploring the mode of commercial insurance's participating in NRCMC in China's other regions
The main innovations of this article are the following:
First, it grasps the key issues of the NRCMC comprehensively by analyzing the all aspects of the NRCMC.
Second, it uses the actuarial model to analyze the problem of inadequate level of funding in the New-type rural cooperative medical financing by the data which the government announced.
Third, this article tries to find the solution by improving the efficiency of using the Cooperative medical care funds and finds the models which the farmers can buy high-quality low-cost health services by the reasonable organizing and providing the medical and health resources, and Innovating the payment systems and the management models.
Also, the survey data sample of the empirical part is limited, so it brings some effect on the analysis of fund-raising of NRCMC; on payment and management, due to lack of corresponding cases in Sichuan Province, this article can only do some exploration on theory to relevant experience at home and abroad, then the extension process may encounter more difficulties in practice. In the course of writing this article, because the author's level and energy are limited, with the best, but the article are still being some inevitable flaws.
第一章绪论部分。该部分概括阐述了新农合产生的背景,发展历程以及本课题研究的意义；介绍了本文研究的内容和采用的方法；通过文献复习,综述了对新农合现阶段存在的问题的相关理论。
第二章四川省新农合现状及关键问题。本章通过四川省新农合现状的描述引出四川省新农合中存在的关键问题。总结出现阶段四川省新农合存在的关键问题主要为：四川省的筹资水平较低；在筹资水平较低的情况下,如何通过医疗服务的组织和管理来提高卫生资源使用效率；以及,如何通过付费制度的改革、管理模式的创新来提高合作医疗资金的使用效率。
第三章四川省新农合筹资水平分析。本章主要通过精算分析,采用实证的方法来说明四川省的筹资水平。该部分从三个方面来说明四川省现阶段的筹资不足：首先,选取四川省筹资水平最高的成都市温江区,以政府公布的数据做一个实证分析；其次,选择经济水平发达的成都市,经济水平中等的绵阳市和经济状况相对较差的内江市,通过实地调研数据,结合精算模型分析其筹资水平；最后通过四川省卫生厅公布的新农合运行数据分析四川省的筹资水平。通过分析可以知道,如果要使四川省的补偿水平达到50%以上,还要极大的提高现阶段的筹资水平,而由于农民有限的缴费能力,政府必须大幅提高新农合的资金补助。
第四章新农合中医疗服务提供的组织与管理。本章主要从优化资源配置,合理的利用医疗卫生资源,加大对医疗服务过程的监管三个方面来探讨。首先,通过对四川省城乡卫生资源分布现状的分析,讨论解决卫生资源分布不均衡的的方法,使农民可以获得更多的优质廉价的卫生服务。其次,双向转诊机制能够促进合理的利用卫生资源,通过对四川省现阶段双向转诊机制存在的问题分析,探讨如何完善双向转诊机制,从而通过提高卫生资源的利用效率来提高新农合基金的使用效率。最后,医疗服务过程中由于其专业性容易产生服务过程中的医疗卫生资源浪费,探讨如何通过加强对医疗服务过程的监管来提高合作医疗基金的利用效率。
第五章新农合中付费及管理模式的改革与创新。另一种有效解决新农合筹资不足问题就是改革付费制度,创新管理模式。通过将现在的医疗付费的后付制转化为预付制,可以将医疗费用风险由合作医疗保险机构控制转化为医疗机构控制,促使医疗机构主动控制医疗费用,提高合作医疗基金的使用效率。在管理模式上,在新农合中引入商业保险公司,’通过利用保险公司保险理念,对保险的专业经营和精算技术,提高新农合的运作效率和资金使用效率。本章主要通过对国内外现阶段主要付费方式的比较,给四川省新农合的付费制度改革提出建议；通过对现阶段我国其它地区的商业保险参与新农合模式的探讨,给四川省新农合管理模式的创新提出建议。
本文的创新之处主要如下：
第一,本文通过系统的分析新农合运行过程中的各个环节,较为准确全面地把握住了其中的关键问题,而不仅仅讨论某个环节中的问题。
第二,通过引入精算模型分析新农合现阶段的筹资水平,以政府公布数据和调研数据作为实证,使得本文对筹资水平不足的问题分析更加具有说服力。
第三,在筹资水平不足的条件下,本文更多的是从提高合作医疗基金利用效率上去寻找解决方案。寻找通过合理的组织和提供医疗卫生资源,革新付费体制和管理模式,使得在现有筹资水平下农民能够购买到优质廉价的卫生服务的模式。
同时,由于本文实证部分的调查数据样本有限,对于新农合中筹资补偿水平的分析可能存在一定的影响；在对于付费体制和管理模式探讨时,由于四川省缺乏相应的案例,本文仅能够借鉴国内外的一些相关经验对其做理论上的探索,在实际推广过程中可能会遇到更多的困难。在本文的撰写过程中,由于笔者的水平和精力有限,虽尽力而为,但文章之中仍难免存在着一些纰漏之处。
In order to solve the occurrence of the farmers'problem that impoverished by hospitalization, and the illness back into poverty, the New Rural Co-operative Medical Care (Referred to as NRCMC) of NRCMC established, which is based on the "CPC Central Committee and State Council on the decision of further strengthening rural health work", promulgated by in October 2002. At present, the analyses of financing, compensation, health service and management models were separated. And the grasp of key issues of the NRCMC is also limited. Sichuan Province is a major agricultural province in the western region. It is useful to promoting the improvement of health level of the farmers in Sichuan Province by the analyses of the key issues of NRCMC. Combining the actual of Sichuan Province, this paper finds the key issue of the NRCMC through the Literature Review and Empirical Methods. And it finds a way to improve the NRCRC. This paper put forward the suggestion for the healthy development of NRCMC through the research on the key issues of the NRCMC. For this reason, this specific research ideas and the logical framework are as follows:
Chapter One:Introduction. This section generalizes the background, development process as well as the researches significant of NRCMC; introduces the contents of this study and the method used; gives an overview of existing theories for the key issues of NRCMC through the literature review.
Chapter Two:The status and key issues of Sichuan Province. Through the description of NRCMC status, this chapter leads to the key issues existing in NRCMC of Sichuan Province. The mainly issues of Sichuan Province's NRCMC are:a low level of funding in Sichuan Province; in the case of low funding levels, how to improve efficiency in the use of health resources through the organization and management of medical services; and, how to improve the efficiency of cooperative medical care funds through the payment system's reform, the management's innovation.
Chapter Three:The analysis of NRCMC financing of Sichuan Province. This chapter is primarily through actuarial analysis to illustrate the funding level in Sichuan Province. That part illustrates the lack of funding at this stage in Sichuan Province from three aspects:First, selecting the highest level of funding in Wenjiang area in Chengdu city of Sichuan Province, making an empirical analysis according to the data released by the Government; Second, choosing the well-developed Chengdu, medium-developed Mianyang and relatively poor Neijiang, analyzing its funding level through field survey data and combined with the actuarial model; Finally, analyzing Sichuan Province's funding level through NRCMC working data announced by Sichuan Provincial Health Department.
Chapter Four:The organization and management provided by the medical service in NRCMC. In the case of funds' shortfall of NRCMC, in order to improve NRCMC working efficiency, one of the best way is to let medical and health institutions provide farmers with more high-quality low-cost medical health services through providing organization and management for medical service. The chapter explores optimizing the allocation of resources, rational use of medical and health resources and increase the regulation of medical service process. First of all, analyzing the distribution status of health resources in urban and rural areas in Sichuan province, discussing the ways to solve the uneven distribution of health resources in which farmers can get more high-quality low-cost health services. Second, the two-way referral mechanism can promote the rational use of health resources. Analyzing the problems in two-way referral mechanism in Sichuan Province at the present, explores how to improve two-way referral mechanism, thereby enhancing NRCMC fund's efficiency from improving efficiency in the use of health resources. Finally, due to the waste of medical health resources in the process of service for it's professional, explores how to improve the utilization efficiency of cooperative medical care funds through strengthening the supervision of the process of health care services.
Chapter Five:The reform and innovation of payment and management mode in NRCMC. Another effective solution to the problem of inadequate financing of NRCMC is to reform payment system and innovate management mode. Changing the current medical paying from post-payment into pre-payment, then the medical organizations can control the risk of medical costs from not cooperative medical insurance institutions, which prompts medical organizations to control medical costs actively and increases the efficient use of cooperative medical care funds On management model, introduced commercial insurance companies in NRCMC, improves the operational efficiency of NRCMC and financial efficiency through the use of the insurance concept, the professional management and actuarial techniques of insurance companies. This chapter gives suggestions to the payment system's reform of Sichuan Province NRCMC through comparing the mainly payment methods at home and abroad; and gives suggestions to management mode's innovation of Sichuan Province NRCMC from exploring the mode of commercial insurance's participating in NRCMC in China's other regions
The main innovations of this article are the following:
First, it grasps the key issues of the NRCMC comprehensively by analyzing the all aspects of the NRCMC.
Second, it uses the actuarial model to analyze the problem of inadequate level of funding in the New-type rural cooperative medical financing by the data which the government announced.
Third, this article tries to find the solution by improving the efficiency of using the Cooperative medical care funds and finds the models which the farmers can buy high-quality low-cost health services by the reasonable organizing and providing the medical and health resources, and Innovating the payment systems and the management models.
Also, the survey data sample of the empirical part is limited, so it brings some effect on the analysis of fund-raising of NRCMC; on payment and management, due to lack of corresponding cases in Sichuan Province, this article can only do some exploration on theory to relevant experience at home and abroad, then the extension process may encounter more difficulties in practice. In the course of writing this article, because the author's level and energy are limited, with the best, but the article are still being some inevitable flaws.
引文
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21四川统计局网上公布
23骆亮,陈颖姣.双向转诊制度实施问题研究.卫生经济研究.2006.11
24关听史张宇.国外社区双向转诊模式及其对我国的借鉴.中国初级卫生保健2009.7
25Bindman, A. B.& Majeed, Azeem. Organization of primary care inthe United States [J]. Primary care. BMJ,2003,326 (22)
26李湘江李士雪郝晓宁.澳大利亚社区卫生服务运行机制和管理模式研究[J].中国卫生事业管理,2007.5
[1]丁少群,李桢.我国新型农村合作医疗及其可持续发展研究.厦门大学出版社.2007.9；188-205
[2]郑小华.四川省新型农村合作医疗补偿方法研究.卫生经济研究.2006.4；26-28
[3]陈晔.新型农村合作医疗筹资方式可持续发展的探析.卫生软科学.2008.2；8-9
[4]陈在余.新型农村合作医疗需求不足的经济学分析.中国卫生经济.2007.3；54-57
[5]王士亨.新型农村合作医疗筹资问题研究.生产力研究.2008.11；34-35
[6]段丁强.新型农村合作医疗筹资机制的改进.财会月刊.2008.4；32-33
[7]王琼,汪占熬.新型农村合作医疗筹资机制研究.农村经济.2008.2；74-76
[8]张晓,刘蓉.社会医疗保险概论.中国社会劳动保障出版社.2004.6；79-87
[9]杨金侠,王禄生,王章泽,温丽娜.新型农村合作医疗医疗费用控制实证研究.——(一).中国卫生经.2008.6；
[10]杨金侠,王禄生,王章泽,温丽娜.新型农村合作医疗医疗费用控制实证研究.——(二)中国卫生经济.2008.7；
[11]王红梅.论农村医疗保障制度建设的现状及其对策.科技经济市场.2008.11；125-127
[12]骆亮,陈颖姣.双向转诊制度实施问题研究.卫生经济研究.2006.11；46-47
[13]关昕,史张宇.国外社区双向转诊模式及其对我国的借鉴.中国初级卫生 保健.2009.7；19-21
[14]李扬,陈文辉.中国农村人身保险市场研究.2005.11；181-199
[15]刘菲.商业保险参与新农合的原因、方式及存在的问题.中国金融.2005.11
[16]应亚珍.论新型农村合作医疗筹资增长机制的构建.中国卫生经济.2008.2
[17]Bindman, A. B.& Majeed, Azeem. Organization of primary care inthe United States. Primary care BMJ,2003,326(22)
[18]李湘江,李士雪,郝晓宁.澳大利亚社区卫生服务运行机制和管理模式研究.中国卫生事业管理.2007.5
[19]吴红军,保险业参与新农合路在何方.金融时报,2008.03.01第005版.
[20]叶宜德,汪时东.新型农村合作医疗及初级卫生保健.合肥工业大学出版社.2004.7
[21]陈滔.健康保险.西南财经大学出版社,2002.2
[22]林义.社会保险.中国金融出版社.2003
[23]陈滔.农村健康保障制度的国际比较.财经科学.2005.6;100-104
[24]陈滔.健康保险精算：模型、方法和应用.中国统计出版社.2007.2
[25]张琴.新型农村合作医疗可持续发展研究：基于医疗服务供给的视角.农业经济问题.2009.2；37-41
[1]中华人民共和国国家统计局http://www. stats.gov.cn/
[2]中华人民共和国劳动与社会保障部http://www. molss.gov.cn/
[3]中华人民共和国卫生部http://www.moh.gov.cn/
[4]中国保险监督管理委员会http://www.circ.gov.cn/
[7]中国健康保险网http://www.zgjkbxw.com/
[8]中国医疗保险网http://www.mib.com.cn/
[9]新型农村合作医疗网http://www.cncms.org.cn/
[10]世界卫生组织http://www.who.int/en/
[11]构建我国多层次医疗保险体系,中国医疗保险网,http://www.mib.com.cn/xinwenzhongxin/redianyanlun/10623_2.html
[12]中国社会保障网http://www.cnss.cn/
2丁少群,李桢.我国新型农村合作医疗及其可持续发展研究.厦门大学出版社.2007.9；188-205
3郑小华.四川省新型农村合作医疗补偿方法研究.卫生经济研究.2006.4；26-28
4陈晔.新型农村合作医疗筹资方式可持续发展的探析.卫生软科学.2008.2；8-9
5陈在余.新型农村合作医疗需求不足的经济学分析.中国卫生经济.2007.3；54-57
6王士亨.新型农村合作医疗筹资问题研究.生产力研究.2008.11；34-35
7段丁强.新型农村合作医疗筹资机制的改进.财会月刊.2008.4；32-33
8骆亮,陈颖姣.双向转诊制度实施问题研究.卫生经济研究.2006.11;46-47
9关听,史张宇.国外社区双向转诊模式及其对我国的借鉴.中国初级卫生保健.2009.7；19-21
10杨金侠,王禄生,王章泽,温丽娜.新型农村合作医疗医疗费用控制实证研究.——(一).中国卫生经.2008.6;杨金侠,王禄生,王章泽,温丽娜.新型农村合作医疗医疗费用控制实证研究.——(二)中国卫生经济.2008.7;
11王红梅.论农村医疗保障制度建设的现状及其对策.科技经济市场.2008.11;125-127
12葛延风.中国青年报访谈.2007
13张成勉,孙永发.我国社区卫生服务中政府购买公共卫生服务项目的难点和建议.中国全科医学.2009.12
14瞿星,苏维.新型农村合作医疗付费方式现状研究.现代预防医学.2008.3
15李扬,陈文辉.中国农村人身保险市场研究.2005.11;181-199
16刘菲.商业保险参与新农合的原因、方式及存在的问题.中国金融.2005.11
19应亚珍.论新型农村合作医疗筹资增长机制的构建.中国卫生经济.2008.2
20郑小华.四川省新型农村合作医疗补偿方法研究.卫生经济研究.2006.4;26-28
21四川统计局网上公布
23骆亮,陈颖姣.双向转诊制度实施问题研究.卫生经济研究.2006.11
24关听史张宇.国外社区双向转诊模式及其对我国的借鉴.中国初级卫生保健2009.7
25Bindman, A. B.& Majeed, Azeem. Organization of primary care inthe United States [J]. Primary care. BMJ,2003,326 (22)
26李湘江李士雪郝晓宁.澳大利亚社区卫生服务运行机制和管理模式研究[J].中国卫生事业管理,2007.5
[1]丁少群,李桢.我国新型农村合作医疗及其可持续发展研究.厦门大学出版社.2007.9；188-205
[2]郑小华.四川省新型农村合作医疗补偿方法研究.卫生经济研究.2006.4；26-28
[3]陈晔.新型农村合作医疗筹资方式可持续发展的探析.卫生软科学.2008.2；8-9
[4]陈在余.新型农村合作医疗需求不足的经济学分析.中国卫生经济.2007.3；54-57
[5]王士亨.新型农村合作医疗筹资问题研究.生产力研究.2008.11；34-35
[6]段丁强.新型农村合作医疗筹资机制的改进.财会月刊.2008.4；32-33
[7]王琼,汪占熬.新型农村合作医疗筹资机制研究.农村经济.2008.2；74-76
[8]张晓,刘蓉.社会医疗保险概论.中国社会劳动保障出版社.2004.6；79-87
[9]杨金侠,王禄生,王章泽,温丽娜.新型农村合作医疗医疗费用控制实证研究.——(一).中国卫生经.2008.6；
[10]杨金侠,王禄生,王章泽,温丽娜.新型农村合作医疗医疗费用控制实证研究.——(二)中国卫生经济.2008.7；
[11]王红梅.论农村医疗保障制度建设的现状及其对策.科技经济市场.2008.11；125-127
[12]骆亮,陈颖姣.双向转诊制度实施问题研究.卫生经济研究.2006.11；46-47
[13]关昕,史张宇.国外社区双向转诊模式及其对我国的借鉴.中国初级卫生 保健.2009.7；19-21
[14]李扬,陈文辉.中国农村人身保险市场研究.2005.11；181-199
[15]刘菲.商业保险参与新农合的原因、方式及存在的问题.中国金融.2005.11
[16]应亚珍.论新型农村合作医疗筹资增长机制的构建.中国卫生经济.2008.2
[17]Bindman, A. B.& Majeed, Azeem. Organization of primary care inthe United States. Primary care BMJ,2003,326(22)
[18]李湘江,李士雪,郝晓宁.澳大利亚社区卫生服务运行机制和管理模式研究.中国卫生事业管理.2007.5
[19]吴红军,保险业参与新农合路在何方.金融时报,2008.03.01第005版.
[20]叶宜德,汪时东.新型农村合作医疗及初级卫生保健.合肥工业大学出版社.2004.7
[21]陈滔.健康保险.西南财经大学出版社,2002.2
[22]林义.社会保险.中国金融出版社.2003
[23]陈滔.农村健康保障制度的国际比较.财经科学.2005.6;100-104
[24]陈滔.健康保险精算：模型、方法和应用.中国统计出版社.2007.2
[25]张琴.新型农村合作医疗可持续发展研究：基于医疗服务供给的视角.农业经济问题.2009.2；37-41
[1]中华人民共和国国家统计局http://www. stats.gov.cn/
[2]中华人民共和国劳动与社会保障部http://www. molss.gov.cn/
[3]中华人民共和国卫生部http://www.moh.gov.cn/
[4]中国保险监督管理委员会http://www.circ.gov.cn/
[7]中国健康保险网http://www.zgjkbxw.com/
[8]中国医疗保险网http://www.mib.com.cn/
[9]新型农村合作医疗网http://www.cncms.org.cn/
[10]世界卫生组织http://www.who.int/en/
[11]构建我国多层次医疗保险体系,中国医疗保险网,http://www.mib.com.cn/xinwenzhongxin/redianyanlun/10623_2.html
[12]中国社会保障网http://www.cnss.cn/