引用本文:茅雯辉,陈文,胡敏,等.试论医保总额控制实施的问题及对策[J].中国卫生政策研究,2013,6(9):9-13 |
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试论医保总额控制实施的问题及对策 |
投稿时间:2013-04-11 修订日期:2013-07-29 PDF全文浏览 HTML全文浏览 |
茅雯辉, 陈文, 胡敏, 张璐莹 |
复旦大学公共卫生学院 上海 200032 |
摘要:从总额控制的基本概念着手,介绍了总额预算的基本概念、分类、作用机制、影响以及优缺点评价,分析并总结了总额控制在我国的实施现状,总额的制定与调整机制、医保机构与医疗机构的协商谈判机制以及医疗服务质量监管机制尚未形成、配套措施落实不到位等是当前我国总额控制实施过程中的主要问题。最后提出因地制宜,选择适宜改革路径;科学测算和设计,综合考量多元化目标;逐步构建多元支付体系,配套措施落实到位等相应对策。 |
关键词:医疗保险 总额控制 问题 对策 |
基金项目:国家社会科学基金重大项目(11&ZD176) |
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Problems and strategy on global budget of basic medical insurance schemes |
MAO Wen-hui, CHEN Wen, HU Min, ZHANG Lu-ying |
School of Public Health, Fudan University, Shanghai 200032, China |
Abstract:This paper introduces the basic concept, recognized categories, and mechanism of global budget. It also analyzes the potential impacts and assesses the merits and demerits of global budget. Current implementations of global budget in China are summarized and problems such as immature of budget measurement and adjustment, negotiation and supervision are analyzed. We suggest adapting the global budget to its health service system, taking multiple targets into account when designing budget incentive mechanisms, setting up a multi-payment system, and completing the supporting system. |
Key words:Medical insurance Global budget Problem Strategy |
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