基于利益相关者的儿童基本医疗保险体系的优化研究精选版.docVIP

tryt ghgh 基于利益相关者的儿童基本医疗保险体系的优化研究 林津晶①②，黄文龙① * 基金项目：福建省科技厅软科学项目（2018R0045） ①中国药科大学国际医药商学院 南京 210009； ②福建中医药大学药学院 福州 350108 作者简介：林津晶（1981—），女，博士在读，讲师，研究方向：医药卫生政策；E-mail： HYPERLINK mailto:penpals@163.com penpals@163.com。 通讯作者：黄文龙， E-mail： HYPERLINK mailto:ydhuangwenlong@126.com ydhuangwenlong@126.com。 摘 要 目的：深入分析儿童基本医疗保险体系中的主要利益相关者，促进儿童基本医疗保险体系的稳定可持续性发展。方法：基于利益相关者理论，明确儿童基本医疗保险的利益相关者，明晰影响儿童基本医疗保险稳定运行的动力与阻力。结果：儿童基本医疗保险体系中的主要利益相关者包括儿童家长、医保管理部门、卫生行政部门、财政及物价管理部门、商业保险公司及医疗机构等。卫生行政部门和医保部门是儿童基本医疗保险稳定运行的主要推动力；财政及物价等部门的协调配合、医疗机构是儿童居民基本医疗保险稳定运行的助推力；患儿家庭有可能成为儿童居民医疗保险稳定性发展的阻碍因素；商业保险公司有可能对儿童参保持负面态度。结论：提出了形成差异化的儿童基本医疗保险制度、提升基层医疗机构的儿童医疗服务能力、加大医保政策及基层医疗机构医疗服务定位的宣传、厘清儿童医疗保险体系中政府和市场的定位等建议。 关键词 儿童；基本医疗保险；利益相关者 中图分类号R1-9；F840.613 文献标志码 A 文章编号：1003-0743（2018）08-0000-00 DOI 10.7664/CHAnalysis of Children Resident Essential Medical Insurance System：Based on Stakeholders Theory/LIN Jin-jing，HUANG Wen-long.//Chinese Health Economics, Abstract Objective：To promote the stable and sustainable development of the basic medical insurance system for children, the main stakeholders in the basic medical insurance system of children are deeply analyzed. Methods: This paper analyzes the major stakeholders of resident essential medical insurance for children and Clarify the driving force and resistance of the medical insurance stability for childrens residents. Results：The main stakeholders in childrens basic medical insurance system include childrens parents, medical insurance management departments, health administrative departments, financial and price management departments, business insurance company and medical institutions. medical insurance management departments, health administrative departments are a major driver of childrens basic medical insurance.Financial and price departments coordination, medical institutions are boost of childrens basic medical insurance. Parents may be hindrance factor. Business insurance company may hold a negative attitude. Conclusion：.Resid