| 引用本文：秦立建,蒋中一.新型农村合作医疗服务外包的实践分析[J].中国卫生政策研究,2011,4(8):29-33 |
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| 新型农村合作医疗服务外包的实践分析 |
| 投稿时间：2011-06-20 修订日期：2011-07-11 PDF全文浏览 HTML全文浏览 |
| 秦立建1, 蒋中一2 |
| 1.安徽财经大学财政与公共管理学院;2.农业部农村经济研究中心 |
| 摘要:新型农村合作医疗是由政府主导实施的基本医疗保障制度，在运行过程中遇到两个问题：难以有效核查异地就诊病例，难以解决经办人员的编制。而福建省晋江市将新型农村合作医疗进行服务外包，实行“筹、监、办”相分离的运行模式，充分利用保险公司的全国性互助稽查网络核查异地就诊病例，并且建立外伤和疑难案件调查制度，为新型农村合作医疗的持续健康发展提供了有益的思路。 |
| 关键词:新型农村合作医疗 商业医疗保险 服务外包 |
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| Analysis on the practice of service out sourcing of New Rural Cooperative Medical Scheme: Based on the survey in Jinjiang, Fujian Province |
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| Abstract:There are two difficulties in the practice of New Rural Cooperative Medical Scheme(NRCMS), which is the basic medical security system conducted by governments. The first is to verify the realness of those cases treated in other areas; and the second is the formal personal establishment of the agency persons. In Jinjiang city, Fujian province, the service outsourcing has been employed to deal with these two problems. In practice, the financing, supervision, management of NRCMS are conducted separately, and the mutual inspecting network of commercial insurance companies nationwide has been used adequately to verify the realness of cases treated in other areas. In addition, the investigating system on traumatisms and hard cases has been established. These practices in Jinjiang have provided useful experience and reference for the sustainable and sound development of NRCMS. |
| Key words:New Rural Cooperative Medical Scheme Commercial health insurance Service outsourcing |
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