防城港市城乡基本医疗保险统筹机制研究行政管理专业论文.docxVIP

本文的主要观点是：针对防城港市城乡基本医疗保险统筹工作进展情 本文的主要观点是：针对防城港市城乡基本医疗保险统筹工作进展情 况，总结了以下几个方面：(1)城乡基本医疗保险统筹过程中取得的成就： 医保覆盖面扩大，重复参保现象得到有效控制；城乡居民医疗保障方面支 出逐年提高；城乡医疗待遇水平得到提高。 (2)城乡基本医疗保险统筹机 制现状：管理权限模糊不清；筹资机制固化；城乡医疗待遇补偿机制不统 一；异地就医即时结算机制不健全；城乡居民大病保险统筹机制不完善。 (3)城乡基本医疗保险统筹机制存在问题的原因如下：未及时整合管理体 制；筹资机制创新性不足；城乡医疗待遇公平机制不健全；医保信息接续 和监督机制不完善；医保政策衔接机制不健全。 本文在总结了国外医疗保险一体化模式和国内广东湛江、宁夏石嘴山 和浙江嘉兴三市的城乡基本医疗保险统筹模式后，提出了健全和完善防城 港市城乡基本医疗保险统筹机制的策略和建议：统一管理体制；完善政策 衔接机制；设置科学合理的、责任分担的筹资机制，通过STATA的图形聚 类分析和BP神经网络科学的分析设计了防城港市城乡居民基本医疗保险的 缴费标准；完善城乡医疗待遇均衡分配机制和异地就医管理体制。研究成 果有助于健全和完善防城港市城乡基本医疗保险统筹机制，可为防城港市 城乡基本医疗保险统筹工作的进一步开展提供参考性的建议。 关键词：基本医疗保险城乡统筹 防城港市整体性治理 万方数据 STUDY STUDY C0-oI①INArnONⅣ匝CHANISM FANGCH团啪ANG URBAN AND RI瓜AI，BASCI M匣DICAL INSI瓜ANCE SYSTEM ABSTRACT The implementation of urban and rural basic medical insurance CO．ordination is the only way to build universal health care system，but also to eliminate the cause of the gap between urban and rural medical security key． Our three basic medical insurance system for urban and rural areas by identity， identity．based employee insurance types，divided into the basic medical ．basicbasic medicaldical insurance fortor urbanurDan reslaen_tsesidents andanti the newnew rural cooperative medical insurance，social security sector management by the former two and the latter by the health department heads，according to three different dispersants run the insured object，the decentralization trend，greatly hindered the cause of Chinas urban and rural medical security harmony development，but also a stumbling block to integration of urban and rural development．However, previous studies on urban and rural basic medical insurance system focused on the necessity of integration of several basic mescal insurance system，feasibility， integration difficulties and countermeasures study on the basic medical insurance system and other aspects of the design，although a small amount about 万方数据 the the Two medical Study CO—ordinate insurance system convergence，but the main concern is the level of con