城镇职工基本医疗保险制度运行中经费支付问题的研究——以岳阳市为例.pdfVIP

更高的医疗服务，提升医保基金的使用效率，研究者们开始更加注重 人性化的设计，关注参保人员的健康诉求和医方的合理要求，而不是 依靠简单的医保基金收支数字确定医疗保险经费控制的效果。 ． 研究通过对国内外相关医疗保险支付方式和费用控制方法进行 综合分析评价，得出对我国医疗保险改革中关于支付方式选择和经费 控制机制构建的借鉴性意见和建议；同时，通过对我省岳阳市十多年 来的医改经验的梳理和总结，根据其支付方式变革的历程，分析评估 不同支付方式对医疗经费支付的控制效果，针对性的提出了四项对策 建议：一是推进医疗卫生体系和药品流通体制改革，使医药保三项改 革同步进行，相辅相成；二是完善医疗保险费用支付方式，实行混合 型支付方式；三是积极发展社区卫生服务体系，引导患者改变医疗消 费观念；四是强化健康管理对医疗保险经费支付的控制。 关键词：城镇职工医疗保险； 经费支付方式；费用控制 II ABSTRACT Medicare is a worldwide problem，the doctor hands of the medical expenses incurred a墨a source of difficulty that the pen is difficult to control in the difficult．Medicare is a colorful field of medical expenses paid by the operating system and its handling is one of the most vivid，the most viable place．Necessary to effectively protect the insured’S medical needs；need to maintain health irlsurailce fund stable,sustainable development，which was controlled within acceptable limits，avoid overspending Fund serious problem affecting the health care system sustainable sex and the insured’S interests． Since the 20th century to the 1 970s，health care costs around the world are showing rapid growth，the pressure also increases health insurance．Faced with this situation，countries began on how to effectively control medical costs conducted in·depth discussion and practice，and gradually formed a unique method of controlling Medicare costs．Medical insurance system reform in China through the past 20 years，China’S universal health care system in addressing the masses ”difficult and expensive”on the issue and achieved good results．But now Chinas medical insurance management methods are still relatively simple， due to the late start of China’S medical insurance system，the lack of practical experience，systems ale not perfect，SO in the face of rising health care costs，1ack of effective，mature control mechanisms． IlI From the individual to the number,postpaid to prepaid，the direction of the development of the micro to the macro world today is paid in Medicare funding of both supply and demand t