| 引用本文：孙冬悦,孙纽云,房珊杉,等.大病医疗保障制度的国际经验及启示[J].中国卫生政策研究,2013,6(1):13-20 |
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| 大病医疗保障制度的国际经验及启示 |
| 投稿时间：2012-12-18 修订日期：2012-12-29 PDF全文浏览 HTML全文浏览 |
| 孙冬悦1, 孙纽云1, 房珊杉1, 董丹丹1, 梁铭会1 |
| 卫生部医院管理研究所 |
| 摘要:为缓解重大疾病带来的沉重负担，国际上绝大多数发达国家都建立了不同模式的大病医疗保障制度，主要有商业医疗保险主导，国家医疗保险主导，社会医疗保险主导三种基本模式。考虑国际上典型国家的大病保障均以本国医疗保障制度为基础，本研究通过介绍三种模式下典型国家医疗保障体系的历史背景、制度框架等内容，分析其对重大疾病的保障模式与特点，总结各国在降低患者自付费用、控制医保付费水平、提高医疗服务质量和效率的相关经验，进而建议我国在制定大病保障政策时，注意采用综合控费措施，降低患者自付费用；转变医保支付方式，控制医保付费水平；加强运行监管,提高医疗质量和效率。 |
| 关键词:医疗保障 大病保险 国际经验 |
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| Catastrophic disease insurance system: International experiences and implications for China |
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| Abstract:In order to mitigate the heavy financial burden of catastrophic diseases on the public, most developed countries have established catastrophic disease insurance models, including commercial, national, and social insurance models Typically, developed countries have a national medical insurance system that covers catastrophic diseases We study the historical context and institutional framework of the general health insurance systems in developed countries， analyze characteristics of different catastrophic disease insurance models and summarize the experiences in reducing patient out of pocket expenses, lowering insurance payments, and improving the quality and efficiency of medical services When formulating policies about catastrophic disease insurance, governments should comprehensively control medical costs to reduce patient expenses, change insurance payment methods to control insurance administration costs, increase operational supervision, and improve the quality and efficiency of medical services |
| Key words:Health insurance Catastrophic disease insurance International experiences |
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