医院发展模式适应医保支付方式改革的思考
|
摘要
医保支付方式改革的一个主要直接目标就是利用支付的经济杠杆作用,促进公立医院补偿机制的转变,推动公立医院改革,控制诱导需求和过度医疗,引导和激励供方将管理重心从经济创收转向医疗安全、质量和效率。医疗机构必须主动适应医保支付方式改革的要求,优化医院发展管理模式,重构战略规划,从财务管理、业务流程、薪酬分配和信息管理等方面入手,实现成本、效率、质量、安全和服务等多元目标。
One of the ultimate objectives of medical insurance payment system reform was to foster the transformation of the compensation mechanism of public hospitals through economic leverage,by which promote public hospitals reform and control supplier-induced demand and excessive utilization of healthcare,ultimately motivate providers to attach more importance to safety,quality and efficiency other than profit. To sustain long-term development,hospitals ought to positively adapt to the requirements of the reform and enhance management capacity,by restructuring strategic planning,financial management,medical processes,salaries distribution,information management,etc,and thus achieve multiple goals such as cost,efficiency,quality,safety and responsiveness.
One of the ultimate objectives of medical insurance payment system reform was to foster the transformation of the compensation mechanism of public hospitals through economic leverage,by which promote public hospitals reform and control supplier-induced demand and excessive utilization of healthcare,ultimately motivate providers to attach more importance to safety,quality and efficiency other than profit. To sustain long-term development,hospitals ought to positively adapt to the requirements of the reform and enhance management capacity,by restructuring strategic planning,financial management,medical processes,salaries distribution,information management,etc,and thus achieve multiple goals such as cost,efficiency,quality,safety and responsiveness.
引文
[1]钟东波.公立医院改革的概念框架[J].中国卫生政策研究,2012,5(4):5-10.
[2]杨敬宇.医保支付制度改革是公立医院补偿机制改革的核心[J].中国医疗保险,2012(10):15-18.
[3]刘亚歌,彭明强.医疗保险费用支付方式改革对医院管理的影响[J].中国医院管理,2011,31(7):52-54.
[4]YIP WCWINNIE CHI-MAN,HSIAO WC,CHEN W,et al.Early appraisal of China’s huge and complex health-care reforms[J].Lancet,2012,379(3):833-842.
[5]张超,沈怡,高臻耀.医保支付方式改革的上海路径[J].中国医疗保险,2011(7):29-31.
[6]姚奕,陈仪,石菊.医疗保险支付方式改革:实践与研究进展评述[J].中国卫生经济,2017,36(4):36-39.
[7]沈华亮.深圳总额控制下复合式医疗保险支付制度的实践[J].中华医院管理杂志,2012,28(10):785-788.
[8]谢春燕,胡善联,孙国桢,等.我国医疗保险费用支付方式改革的探索与经验[J].中国卫生经济,2010,29(5):27-29.
[9]张振忠.我国公立医院医疗服务支付制度改革与发展的思考[J].中华医院管理杂志,2010,26(10):725-728.
[10]PREKER A S,LINDNER M E,CHER-NICHOVSKY D,et al.Scaling up affordable health insurance:staying the course[M].Washington DC.:The World Bank,2013:137-139.
[11]李伟光,杨丽华,李俊,等.医疗保险付费方式改革对医院的影响极其对策[J].中华医院管理杂志,2010,26(6):464-465.
[12]郑大喜.医保支付方式改革对医院财务管理的影响[J].医学与社会,2013,26(2):55-58.
[13]郭莺,高鑫.医院如何适应医保支付方式改革[J].中国社会保障,2010(5):82-83.
[14]王兵,邵建华,阎元.医院适应医保预付制改革的探索与思考[J].中国医疗保险,2011(8):47-49.
[15]张蘅,闫冰.总额预付改革下精细化医保住院指标的实施[J].中国医院管理,2012,32(6):43-44.
[2]杨敬宇.医保支付制度改革是公立医院补偿机制改革的核心[J].中国医疗保险,2012(10):15-18.
[3]刘亚歌,彭明强.医疗保险费用支付方式改革对医院管理的影响[J].中国医院管理,2011,31(7):52-54.
[4]YIP WCWINNIE CHI-MAN,HSIAO WC,CHEN W,et al.Early appraisal of China’s huge and complex health-care reforms[J].Lancet,2012,379(3):833-842.
[5]张超,沈怡,高臻耀.医保支付方式改革的上海路径[J].中国医疗保险,2011(7):29-31.
[6]姚奕,陈仪,石菊.医疗保险支付方式改革:实践与研究进展评述[J].中国卫生经济,2017,36(4):36-39.
[7]沈华亮.深圳总额控制下复合式医疗保险支付制度的实践[J].中华医院管理杂志,2012,28(10):785-788.
[8]谢春燕,胡善联,孙国桢,等.我国医疗保险费用支付方式改革的探索与经验[J].中国卫生经济,2010,29(5):27-29.
[9]张振忠.我国公立医院医疗服务支付制度改革与发展的思考[J].中华医院管理杂志,2010,26(10):725-728.
[10]PREKER A S,LINDNER M E,CHER-NICHOVSKY D,et al.Scaling up affordable health insurance:staying the course[M].Washington DC.:The World Bank,2013:137-139.
[11]李伟光,杨丽华,李俊,等.医疗保险付费方式改革对医院的影响极其对策[J].中华医院管理杂志,2010,26(6):464-465.
[12]郑大喜.医保支付方式改革对医院财务管理的影响[J].医学与社会,2013,26(2):55-58.
[13]郭莺,高鑫.医院如何适应医保支付方式改革[J].中国社会保障,2010(5):82-83.
[14]王兵,邵建华,阎元.医院适应医保预付制改革的探索与思考[J].中国医疗保险,2011(8):47-49.
[15]张蘅,闫冰.总额预付改革下精细化医保住院指标的实施[J].中国医院管理,2012,32(6):43-44.