摘要
本研究以深圳市的分级诊疗实践为基础,深入分析了医保政策在推动分级诊疗体系改革中的经验及挑战。文章提出,在“三医”协同发展和治理的框架下,医保政策应采取渐进式策略,通过就医管理和差异化报销政策引导基层就医,利用多元化复合支付机制激励医疗机构间的合作与健康管理,并通过异地就医直接结算、电子处方流转等措施增强基层医疗机构的服务能力。
This article takes the practice of hierarchical diagnosis and treatment in Shenzhen City as an example to analyze the experience and challenge of medical insurance policies in promoting the reform of the hierarchical diagnosis and treatment system.This article believes that medical insurance policy should gradually guide grassroots medical treatment through medical management and differentiated reimbursement policies in the context of the coordinated development and governance of medical insurance,medical services,and pharmaceuticals.Multiple composite payment methods should be used to incentivize cooperation and health management among medical institutions,and methods such as direct settlement of medical expenses in different regions and electronic prescription circulation should be used to help improve the service capabilities of grassroots medical institutions.
出处
《中国医疗保险》
2024年第10期85-90,共6页
China Health Insurance
关键词
分级诊疗
医保政策
“三医”协同
graded diagnosis and treatment
medical insurance policy
coordination of medical insurance
medical services
and pharmaceuticals
作者简介
通讯作者:彭婧婷,武汉大学政治与公共管理学院硕士研究生在读,E-mail:6805220@qq.com。
