| 引用本文：牛亚冬, 张亮, 张翔, 吴建, 苗豫东.医保系统和医疗系统协同发展探讨：目标、分工与协作[J].中国卫生政策研究,2023,16(10):35-40 |
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| 医保系统和医疗系统协同发展探讨：目标、分工与协作 |
| 投稿时间：2023-08-09 修订日期：2023-09-06 PDF全文浏览 HTML全文浏览 |
| 牛亚冬1, 张亮2, 张翔3,4, 吴建1, 苗豫东1 |
1. 郑州大学公共卫生学院 河南郑州 450001;
2. 武汉大学政治与公共管理学院 湖北武汉 430072;
3. 华中科技大学同济医学院医药卫生管理学院 湖北武汉 430030;
4. 湖北省人文社科重点研究基地农村健康服务研究中心 湖北武汉 430030 |
| 摘要:协同发展是提高医保系统和医疗系统效率的关键，但当前医保系统和医疗系统更多的是孤立式改革和表面上联动。本文从价值角度分析了医保系统和医疗系统协同发展的可行性，从可持续发展角度分析了二者的协同发展目标，即可持续健康，包括提高居民健康水平、构建分级有序服务秩序、控制卫生服务成本三个子目标，并以此为基础梳理了医保系统和医疗系统各自的分工和协作机制，以期为两个系统的协同改革提供借鉴。 |
| 关键词:医保系统 医疗系统 协同发展 协同目标 |
| 基金项目:国家自然科学基金重点项目(71734003) |
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| Discussion on the coordinated development of health insurance system and medical system: Target, division and coordination |
| NIU Ya-dong1, ZHANG Liang2, ZHANG Xiang3,4, WU Jian1, MIAO Yu-dong1 |
1. School of Public Health, Zhengzhou University, Zhengzhou Henan 450001, China;
2. School of Public Science and Public Administration, Wuhan University, Wuhan Hubei 430072, China;
3. School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan Hubei 430030, China;
4. Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan Hubei 430030, China |
| Abstract:Coordinated development is the key to improving the efficiency of the health insurance system and the medical system, but the current health insurance system and the medical system are more isolated reforms and superficial linkages. This paper analyzes the feasibility of the coordinated development of the health insurance system and the medical system from the perspective of value, and analyzes the synergistic development goals of the two from the perspective of sustainable development, namely sustainable health (including three sub-goals: improving the health level of residents, building a hierarchical and orderly service order, and controlling the cost of health services), and on this basis, the division of responsibility and coordination mechanism between the health insurance system and the medical system are sorted out, in order to provide reference for the collaborative reform of the two systems. |
| Key words:Health insurance system Medical system Coordinated development Coordinated target |
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