發(fā)布時(shí)間：2018-08-30 17:24

【摘要】：本文首先對(duì)新農(nóng)合制度進(jìn)行詳細(xì)的介紹，包括新農(nóng)合制度產(chǎn)生的背景、新農(nóng)合的演變過(guò)程，以及通過(guò)對(duì)比研究，探討新型農(nóng)村合作醫(yī)療制度與傳統(tǒng)農(nóng)村合作醫(yī)療的不同點(diǎn)，突出新農(nóng)合制度的好處和優(yōu)勢(shì)，同時(shí)還分析新農(nóng)合制度自啟動(dòng)以來(lái)每年的發(fā)展情況，分析新農(nóng)合在發(fā)展過(guò)程中存在的問(wèn)題，為下文研究該制度的機(jī)理提供現(xiàn)實(shí)參考依據(jù)。 接著，本文研究新農(nóng)合制度中政府補(bǔ)貼合同優(yōu)化設(shè)計(jì)，通過(guò)構(gòu)造政府、新農(nóng)合基金管理機(jī)構(gòu)、農(nóng)民這三大主體的委托代理模型，利用數(shù)學(xué)方法，得到新農(nóng)村合作醫(yī)療保險(xiǎn)制度中最優(yōu)的參合費(fèi)用、最優(yōu)政府補(bǔ)貼金額以及農(nóng)民患病后所獲報(bào)銷比例的理論最優(yōu)值。探討在政府財(cái)政預(yù)算之內(nèi)，在保障新農(nóng)村合作醫(yī)療保險(xiǎn)制度持續(xù)發(fā)展的前提下，如何吸引更多的農(nóng)民參合。本文通過(guò)分析得到在某些條件下，新農(nóng)合基金管理機(jī)構(gòu)會(huì)套取新農(nóng)合基金，騙取政府的財(cái)政補(bǔ)貼，導(dǎo)致沒(méi)有農(nóng)民愿意參與新農(nóng)合。在這種情況下，為了讓農(nóng)民信任并且真正從新農(nóng)合制度中受益，政府必須采取一些措施來(lái)監(jiān)管和規(guī)范新農(nóng)合基金管理機(jī)構(gòu)的行為。 最后，本文研究新農(nóng)合定點(diǎn)醫(yī)療機(jī)構(gòu)的選擇策略，探討在兩類醫(yī)療服務(wù)水平不同的醫(yī)院中如何選擇定點(diǎn)醫(yī)療機(jī)構(gòu)能使得看病的參合患者達(dá)到最多。文章的最后通過(guò)數(shù)值試驗(yàn)說(shuō)明：選擇三甲醫(yī)院作為定點(diǎn)醫(yī)療機(jī)構(gòu)時(shí)，，看病的總?cè)藬?shù)比選擇社區(qū)醫(yī)院作為定點(diǎn)醫(yī)療機(jī)構(gòu)時(shí)看病的總?cè)藬?shù)多，而且兩種情況下看病總?cè)藬?shù)的差值隨著報(bào)銷比例的增大而增大。通過(guò)分析兩種情況下政府的預(yù)算還得到，當(dāng)參合患者對(duì)三甲醫(yī)院醫(yī)療服務(wù)水平的感知價(jià)值非常接近對(duì)社區(qū)醫(yī)院醫(yī)療服務(wù)水平的感知價(jià)值時(shí)，政府對(duì)定點(diǎn)醫(yī)療醫(yī)院的選擇存在一個(gè)最優(yōu)策略。該策略是，選擇醫(yī)療服務(wù)水平比較高的三甲醫(yī)院作為定點(diǎn)醫(yī)療機(jī)構(gòu)，能在保證看病人數(shù)最多的基礎(chǔ)上，實(shí)現(xiàn)政府預(yù)算的最小化。
[Abstract]:This paper firstly introduces the new rural cooperative medical system in detail, including the background of the new rural cooperative medical system, the evolution process of the new rural cooperative medical system, and discusses the differences between the new rural cooperative medical system and the traditional rural cooperative medical system through comparative study. This paper highlights the advantages and advantages of the new agricultural cooperation system, analyzes the annual development of the new rural cooperation system since its inception, analyzes the problems existing in the development process of the new rural cooperation system, and provides a practical reference basis for the following study of the mechanism of the new agricultural cooperation system. Then, this paper studies the optimal design of the government subsidy contract in the new agricultural cooperation system. By constructing the principal-agent model of the government, the management agency of the new agricultural cooperative fund and the farmers, this paper uses the mathematical method. The theoretical optimal value of the optimal participation cost, the optimal government subsidy amount and the proportion of farmers' reimbursement after illness in the new rural cooperative medical insurance system are obtained. This paper discusses how to attract more farmers to participate in the cooperative medical insurance system under the premise of ensuring the sustainable development of the new rural cooperative medical insurance system within the government budget. In this paper, under some conditions, the new rural cooperative fund management agency will take the new rural cooperative fund, defrauding the government of financial subsidies, leading to no farmers willing to participate in the new rural cooperation. In this case, in order to make farmers trust and really benefit from the new rural cooperative system, the government must take some measures to supervise and regulate the behavior of the new rural cooperative fund management agency. Finally, this paper studies the selection strategy of NCMS designated medical institutions, and discusses how to select designated medical institutions in two kinds of hospitals with different levels of medical service. At the end of the paper, the numerical experiments show that the total number of doctors in the third Class A Hospital is more than that in the Community Hospital. And the difference between the total number of patients increased with the increase of reimbursement ratio. Through the analysis of the government budget in two cases, when the perceived value of the participating patients to the medical service level of the third Class A hospital is very close to the perceived value of the community hospital medical service level, The government has an optimal strategy for the selection of designated hospitals. The strategy is to select the third Class A Hospital which has a high level of medical service as a designated medical institution, which can minimize the government budget on the basis of ensuring the largest number of patients.
【學(xué)位授予單位】：華南理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：F323.89;R197.1;F842.684

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