差异化医保政策对推进分级诊疗制度的影响
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摘要
分级诊疗制度的有效推进对于新医改成功有着非常重要的作用,而差异化医保政策能够对患者就医流向起到积极的引导作用。作者在总结部分国家和地区通过差异化医保政策推进分级诊疗制度经验的基础上,对国内部分分级诊疗试点地区差异化医保政策进行比较,并着重分析北京市相关政策的效果及影响,从差异化医保政策的视角提出推进分级诊疗的政策建议。
The effective promotion of the hierarchical medical system plays a decisive role in the success of medical reform, and the differentiated medical insurance policy can play a positive guiding role in the direction of patients' medical treatments. Based on the summary of promoting hierarchical medical system by differential medical insurance policy in foreign typical system of country and on the basis of pilot area in China, the effect of the effect of the relevant policies in Beijing have been heavily analyzed and suggestions have also presented.
The effective promotion of the hierarchical medical system plays a decisive role in the success of medical reform, and the differentiated medical insurance policy can play a positive guiding role in the direction of patients' medical treatments. Based on the summary of promoting hierarchical medical system by differential medical insurance policy in foreign typical system of country and on the basis of pilot area in China, the effect of the effect of the relevant policies in Beijing have been heavily analyzed and suggestions have also presented.
引文
[1]王震,蔡雪妮,王清华.医保报销政策能否引导分级诊疗--基于江苏某市的调查[J].中国医疗保险,2017(5):10-13.
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[3]孙晓凡,陈旻洁,闻大翔.英、美、荷、澳、日分级诊疗实践的启示[J].中国卫生质量管理,2016,23(5):105-108.
[4]赵斌,李蔚.社会医疗保险背景下的分级诊疗制度国际借鉴及中国困境[J].中国医疗保险,2017(5):14-19.
[5]顾亚明.日本分级诊疗制度及其对我国的启示[J].卫生经济研究,2015,32(3):8-12.
[6]王辰旸,田侃,崔璨.台湾地区全民健保下分级诊疗制度之借鉴[J].中国医院管理,2016,36(8):73-75.
[7]连鸿凯,郝义彬,丁凡.国内外医疗服务体系及分级诊疗管理现状[M].河南:郑州大学出出版社,2016.
[8]邢春利,彭明强.我国实施分级诊疗制度的现状及其思考[J].中国医疗管理科学,2015,5(2):9-13.
[9]李颖.开发性金融参与我国分级诊疗制度建设的思考[J].宏观经济理,2017(10):41-48.
[10]医疗器械经销商联盟.北京重点提升基层医疗服务大医院“战时”状态缓解[EB/OL].(2018-04-24)[2018-05-19].http://m.sohu.com/a/229262882_461487.
[11]央广网.北京医改半年成绩单:分级诊疗显成效患者流向到基层机构[EB/OL].(2017-10-18)[2018-05-20].http://baijiahao.baidu.com/s?id=1581550302428521160&wfr=spider&for=pc.
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[13]杨立成,鲍琳辉,田义娟,等.医联体模式下构建双向转诊机制的探讨[J].中国医院,2015,19(7):33-35.
[14]杜杏利,高欢,李卉,等.国内外医联体及分级诊疗构建模式对比与思考[J].中国医院,2017,21(12):40-42.
[2]徐一华,张向阳,周蒙滔.我国医保差异化支付相关政策分析[J].医学与社会,2017,30(2):1-4.
[3]孙晓凡,陈旻洁,闻大翔.英、美、荷、澳、日分级诊疗实践的启示[J].中国卫生质量管理,2016,23(5):105-108.
[4]赵斌,李蔚.社会医疗保险背景下的分级诊疗制度国际借鉴及中国困境[J].中国医疗保险,2017(5):14-19.
[5]顾亚明.日本分级诊疗制度及其对我国的启示[J].卫生经济研究,2015,32(3):8-12.
[6]王辰旸,田侃,崔璨.台湾地区全民健保下分级诊疗制度之借鉴[J].中国医院管理,2016,36(8):73-75.
[7]连鸿凯,郝义彬,丁凡.国内外医疗服务体系及分级诊疗管理现状[M].河南:郑州大学出出版社,2016.
[8]邢春利,彭明强.我国实施分级诊疗制度的现状及其思考[J].中国医疗管理科学,2015,5(2):9-13.
[9]李颖.开发性金融参与我国分级诊疗制度建设的思考[J].宏观经济理,2017(10):41-48.
[10]医疗器械经销商联盟.北京重点提升基层医疗服务大医院“战时”状态缓解[EB/OL].(2018-04-24)[2018-05-19].http://m.sohu.com/a/229262882_461487.
[11]央广网.北京医改半年成绩单:分级诊疗显成效患者流向到基层机构[EB/OL].(2017-10-18)[2018-05-20].http://baijiahao.baidu.com/s?id=1581550302428521160&wfr=spider&for=pc.
[12]杨懿瑾.北京医改一周年:分级诊疗成效明显.[EB/OL].(2018-04-20)[2018-05-25].http://www.bj.xinhuanet.com/tt/2018-04/20/c_1122717042.htm.
[13]杨立成,鲍琳辉,田义娟,等.医联体模式下构建双向转诊机制的探讨[J].中国医院,2015,19(7):33-35.
[14]杜杏利,高欢,李卉,等.国内外医联体及分级诊疗构建模式对比与思考[J].中国医院,2017,21(12):40-42.