韩国医疗保障体系及其运行方式研究

 
投稿时间: 2015-09-23  最后修改时间: 2015-11-04  摘要点击次数: 2331  全文下载次数: 6
 
引用本文:常峰, 纪美艳, 路云,等.韩国医疗保障体系及其运行方式研究[J].中国卫生政策研究,2015,8(12):41-46
常峰1, 纪美艳1, 路云2, 崔鹏磊2, 祝小锐2
1. 中国药科大学国际医药商学院 江苏南京 211198;
2. 东南大学公共卫生学院 江苏南京 210009
基金项目:2014年度江苏省哲学社会科学基金(14ZHB002)
 
 摘要:目的:探讨韩国医疗保障支付体系及其运行方式,为我国医疗保险制度的完善提供借鉴。方法:研究韩国医疗保障制度的基本特点,重点针对其政府采取的基于价值的医疗保险审核与评估支付制度改革经验和制衡式补偿机制。结果:韩国的医疗保障制度特别是其支付制度取得了较好的政策效果。结论:基于价值的医疗保障支付体系推动韩国卫生费用支出降低、卫生政策科学制定。 
  关键词:基于价值  疾病诊断相关分组支付  审核  医疗保障体系
 
Research on the medical insurance system and operating mode in South Korea
CHANG Feng1, JI Mei-yan1, LU Yun2, CUI Peng-lei2, ZHU Xiao-rui2
1. School of Pharmaceutical Business of China Pharmaceutical University, Nanjing Jiangsu 211198, China;
2. School of Pubilic Health School, Southeast University, Nanjing Jiangsu 210009, China
 
 Abstract:Objectives To provide reference for the improve of health care system and healthcare insurance controlling method, through researching on the value-based healthcare paying system in South Korea. Methods The basic characteristics of the Korean health care system was researched, Specifically, its reform experiences of value-based health insurance review and assessment paying system,which government took. Results South Korea's health care paying system had achieved both good social and policy effects. Conclusions Value-based health care paying system is the main reason for the reducing of health care expenditures and making of scientific health policy. 
 keywords:Value-based  DRG-based payment  Review  Medical security system