基于参与约束条件的按人头付费支付标准测算
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  • 英文篇名:Research on Payment Standard of Capitation Based on Participation Constraint
  • 作者:陈振生 ; 甘筱青
  • 英文作者:CHEN Zhen-sheng;GAN Xiao-qing;School of Management, Nanchang University;
  • 关键词:医疗保障 ; 按人头付费 ; 支付标准
  • 英文关键词:medical insurance;;capitation;;payment standard
  • 中文刊名:WEIJ
  • 英文刊名:Chinese Health Economics
  • 机构:南昌大学管理学院;九江学院;
  • 出版日期:2019-06-05
  • 出版单位:中国卫生经济
  • 年:2019
  • 期:v.38;No.436
  • 基金:国家自然科学基金项目(71663034)
  • 语种:中文;
  • 页:WEIJ201906008
  • 页数:2
  • CN:06
  • ISSN:23-1042/F
  • 分类号:22-23
摘要
目的:估测按人头付费支付标准。方法:统计分析和信息经济学中的参与约束条件。结果 :按人头付费支付标准其由分担的保留效用、患病的平均治疗成本和弥补医院亏损的风险成本三部分构成。结论:为了更好实行按人头付费,需要加大参保人员人数、无差异的接纳参保人员以及并对医院的医疗服务质量进行监督,并根据保障范围、时间、质量等因素对支付标准进行调整。
        Objective: To establish the payment standard of capitation. Methods: participation constraints in statistical analysis and information economics were applied. Results: The payment standard of capitation included three parts: the shared retention utility, the average treatment cost of illness and the risk cost of making up the loss of the hospital. Conclusion: To better implement capitation, it was necessary to increase the number of insured personnel, accept them indiscriminately, and supervise the quality of medical services in hospitals, and reasonably determine the payment standard according to the factors of coverage, time and quality.
引文
[1]江芹,张振忠,赵颖旭,等.对“按人头付费”原理及设计的思考[J].中国卫生经济,2013,32(1):34-38.
    [2]蔡高晨,董朝晖.按人头付费的“常德模式”[J].中国社会保障. 2014(2):76-79.
    [3]邓倩,吴荣海,肖黎,等.台湾地区全民健康保险按人头付费改革介绍及述评[J].中国卫生经济. 2015,34(8):28-31.

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