| 引用本文：贺小林,梁鸿.社区卫生服务门诊统筹政策的成效与经验[J].中国卫生政策研究,2011,4(4):16-21 |
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| 社区卫生服务门诊统筹政策的成效与经验 |
| 投稿时间：2011-02-22 修订日期：2011-04-03 PDF全文浏览 HTML全文浏览 |
| 贺小林, 梁鸿 |
| 复旦大学社会发展与公共政策学院 |
| 摘要:在我国城镇居民基本医疗保险筹资水平较低而基本医疗保障需求较高的现实条件下，门诊统筹是提高保障水平、扩大受益面的关键。与社区卫生服务相结合，城镇居民基本医疗保险可以利用其方便价廉、安全有效的特征，充分发挥社区卫生服务的公益性及其高效率的服务优势来保障城镇居民的基本医疗和公共卫生服务。通过典型地区的实证分析，认为门诊统筹具有提高社区卫生服务公益性，提升医保资金使用效率等政策成效。试点地区的经验也表明，依托社区卫生服务的门诊统筹政策成功的原因在于典型地区都进行了服务模式转变的形态机制建设、强化公益性的运行机制建设以及提升能力的社区卫生服务内涵建设。 |
| 关键词:社区卫生服务 城镇居民基本医疗保险 门诊统筹 成效 经验 |
| 基金项目:2009年度国家社会科学基金重大项目（09&ZD059），复旦大学国家哲学社会科学公共管理与公共政策创新基地2008年项目（08FCZD013）, 2011年中国社区卫生科研基金。 |
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| The effectiveness and experiences of pooling outpatient policy in Community Health Services |
| HE Xiao-lin, LIANG Hong |
| School of Social Development and Public Policy, Fudan University |
| Abstract:The pooling outpatient service is a key to increase access and improve the overall security level under the actual condition that the low financing of Basic Medical Insurance for Urban Residents but a relative higher needs for the basic health insurance. Through pooling outpatient service at the community level, it could take advantage of convenient with relative cheaper price, and relative effectiveness for Basic Health Insurance for Urban Resident. Then, it further promotes the public welfare of community health service and in turn to secure the essential medical service and public health service to urban residents. In this paper, an empirical analysis of the typical regiones indicates that pooling outpatient at community health services have the policy effectiveness of improved public welfare, enhance the efficiency of medical insurance funds. The experience of the pilot areas also shows that pooling outpatient service is successful because the typical regiones all had the reform in service transition in the form of services mechanism, the building of operation mechanisms to strengthen public welfare and the content built to enhance the capacity of community health service. |
| Key words:Community Health Services Basic Medical Insurance for Urban Residents Pooling outpatient Effectiveness Experience |
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