摘要
医疗责任保险是分散危险和减少损失、应对医患纠纷的有效制度。本文以福建省属14家公立医院医疗责任险共保体为例,分析其医疗责任保险运营模式、筹资方式及保费计算,并运用各参保医院2016-2020年保费筹资数据,探讨完善区域医疗责任保险筹资模型。研究结论显示:保费筹资应增加医院的在职职工数、实有床位数、医疗性收入等与诊疗活动相关的维度作为筹资计费基础,并将保费筹资由医院与医务人员按比例分担。最后,本文提出完善医疗责任保险的政策建议:保险回归本源,增加保险筹资维度;提高医疗责任险覆盖率,完善"保调赔防"调解机制;整合多方力量,推广和普及医疗责任险;突显第三方作用,构建多元共治模式。
Medical liability insurance is an effective system which could disperse risks, reduce losses and deal with doctor-patient disputes. This study takes the co-insurers of medical liability insurance of 14 medical institutions in Fujian Province as an example to analyze the medical liability insurance model, financing method and premium calculation, and investigate a impeccable regional medical liability insurance financing model based on the premium financing data of all insured hospitals from 2016 to 2020.The results showed that thein order to promote regional medical liability insurance in an orderly manner,premium financing should increase the number of medical staff and hospital beds, medical income(excluding the income of drugs and health materials) and other dimensions related to diagnosis and treatment activities as the basis of financing and charging, and share the premium financing between medical institutions and medical staff in proportion. Finally, our current paper puts forward some suggestions to improve the policy of medical liability insurance: return to the origin of insurance, increase the financing dimension of insurance, increase the coverage rate of medical liability insurance, and improve the mediation mechanism of "protection, adjustment, compensation and prevention", integrate various forces, popularize and popularize medical liability insurance, highlight the role of the third party and build a multi-governance model.
出处
《价格理论与实践》
北大核心
2020年第12期83-86,共4页
Price:Theory & Practice
关键词
医疗责任保险
筹资模型
探索与对策
medical liability
insurance financing model
empirical research
