天津市城镇职工基本医疗保险制度研究

发布时间：2018-04-02 16:06

本文选题：天津市　切入点：城镇职工　出处：《天津大学》2013年硕士论文

【摘要】：随着市场经济体制的建立与发展，与之配套的社会保障制度也在不断完善。作为受众范围最广的医疗保障制度，其改革与发展直接影响着群众的基本生活，成为百姓关注的焦点、热点问题。在我国，各省市都根据本地实际建立了城镇职工基本医疗保险制度。天津市也结合本市具体情况建立了符合经济社会发展现状的医疗保险制度，并不断改革完善。本文通过对天津市城镇职工基本医疗保险的改革发展进行梳理，将其发展历程分为探索、起步、延伸和完善四个阶段，通过发放调查问卷、访谈的方式，对医疗保险群众满意度进行评价，发现其在实际操作过程中出现的很多问题，，主要包括：医疗费用增长过快，医保基金压力巨大；定点医院运行效率不高，看病难、看病贵问题突出；基层医院地位不保，基础功能发挥不强；对患小病人员及健康人员缺乏激励引导机制；社会诚信低下，以药养医风气盛行；经办机构管理创新不足，服务水平有待提升的问题。针对这些问题，文章结合外省市医疗保险制度建设的有益经验，对存在问题进行研究分析，提出要推进门诊统筹、创新制度管理、探索发展商业医疗保险等完善天津市城镇职工基本医疗保险制度的具体措施与方法。
[Abstract]:With the establishment and development of market economy system, the social security system is improving.As the most extensive medical security system, its reform and development directly affect the basic life of the masses and become the focus and hot issues of the people.In China, provinces and cities have established a basic medical insurance system for urban workers according to the actual local conditions.Tianjin also established a medical insurance system in line with the current situation of economic and social development, and continued to reform and perfect.By combing the reform and development of basic medical insurance for urban workers in Tianjin, this paper divides its development process into four stages: exploring, starting, extending and perfecting, issuing questionnaires and interviews.The evaluation of the satisfaction of the masses of medical insurance found that many problems appeared in the actual operation process, including: the rapid growth of medical expenses, the huge pressure of medical insurance fund, the low operating efficiency of designated hospitals, and the difficulty of seeing doctors.The problem of expensive medical treatment is prominent; the status of grass-roots hospitals is not guaranteed, the basic functions are not played well; the lack of incentive and guidance mechanism for patients with minor illnesses and health personnel; the low social integrity, the prevailing atmosphere of keeping doctors with drugs; and the lack of innovation in the management of administrative institutions,Service level needs to be improved.In view of these problems, the article combines the beneficial experience of the medical insurance system construction in other provinces and cities, carries on the research and analysis to the existing problems, proposes to promote the out-patient coordination, innovates the system management,To explore the development of commercial medical insurance and other measures to improve the basic medical insurance system for urban workers in Tianjin.
【学位授予单位】：天津大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F842.684;R197.1

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