| 引用本文：王世强,王卉,张姝,等.基于政策工具的我国医保异地就医结算政策分析[J].中国卫生政策研究,2025,18(10):32-39 |
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| 基于政策工具的我国医保异地就医结算政策分析 |
| 投稿时间：2025-08-27 修订日期：2025-10-10 PDF全文浏览 HTML全文浏览 |
| 王世强1，王卉2，张姝3，张梓祺1，李奕洁1，刘鎵仪4，胡国恒5 |
| 1.首都经济贸易大学城市经济与公共管理学院 北京 100070;2.澳大利亚国立大学数学科学学院;澳大利亚堪培拉 2601;3.中国人民大学公共管理学院 北京 100872;4.北京大学医学部 北京 100083;5.燕山大学文法学院（公共管理学院） 河北秦皇岛 066004 |
| 摘要:目的 系统梳理我国医保异地就医结算相关政策的发布情况及特点，为推动医保异地就医结算服务便捷化和提升管理效能提供参考。方法 基于内容分析法构建“政策目标—政策工具”二维框架，对127份政策文件进行文本编码与分析。结果 在政策工具方面，相较于环境型工具和供给型工具，需求型工具的应用频率最高（43.6%）；在政策目标方面，提高服务便捷性是政策重点，形成了以服务便捷为核心、范围拓展为支撑、监管保障为底线的目标体系。结论 我国医保异地就医结算政策在推进服务便捷性和强化制度监管的同时，兼顾服务覆盖范围的逐步扩大，但在考核评价的精细化和应急机制的完善方面仍有提升空间。因此，各部门间应进一步加强统筹协调，确保监管形成有效衔接，保障医保基金安全运行。 |
| 关键词:异地就医 政策目标 政策工具 政策文本 |
| 基金项目:国家社会科学基金青年项目（24CGL128） |
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| Analysis of China's cross-regional medical insurance settlement policy based on policy tools |
| WANG Shi-qiang1, WANG Hui2, ZHANG Shu3, ZHANG Zi-qi1, LI Yi-jie1, LIU Jia-yi4, HU Guo-heng5 |
| 1.School of Urban Economics and Public Management， Capital University of Economics and Business， Beijing 100070， China;2.Mathematical Sciences Institute， Australian National University， Canberra 2601， Australia;3.School of Public Administration， Renmin University of China， Beijing 100872， China;4.Peking University Health Science Center， Beijing 100083， China;5.School of Law and Law （School of Public Administration）， Yanshan University， Qinhuangdao Hebei 066004， China |
| Abstract:Objective Systematically review the release status and characteristics of policies related to cross-regional medical insurance settlement policies in China， providing reference for promoting the convenience of medical insurance settlement services and improving management efficiency.Methods Using content analysis， a two-dimensional framework of "policy objectives-policy tools" was constructed. A total of 127 policy documents were coded and analyzed.Results Demand-based tools were applied most frequently（43.6%）， followed by environmental and supply-based tools. Policy objectives mainly focused on improving service convenience， supported by expanding coverage and ensuring regulatory security.Conclusions China’s cross-regional medical insurance settlement policies have improved service accessibility and strengthened institutional supervision while gradually expanding coverage. However， deficiencies remain in assessment refinement and emergency mechanisms. Greater interdepartmental coordination is needed to enhance regulatory linkage and ensure the safe operation of medical insurance funds. |
| Key words:Cross-regional medical treatment Policy objectives Policy tools Policy text |
| 摘要点击次数: 105 全文下载次数: 21 |
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