河北省城镇职工基本医疗保险异地就医管理问题研究

发布时间：2018-04-29 13:32

本文选题：河北省 + 城镇职工　；参考：《华北理工大学》2017年硕士论文

【摘要】：改革开放以来中国社会经济的快速发展推动了劳动力的流动,跨区域就业已成常态。中国的医疗保险目前统筹层次仍然不高,各统筹地区医疗保险政策不完全一致。跨区域就医与各统筹区域的医保政策差异,使异地就医管理成为当前医保工作的难点,这一问题值得进行研究。本研究采用了文献研究、内容分析和比较分析的方法,首先对国内外研究现状及本文研究方案进行阐述,之后介绍河北省异地就医管理的相关政策规范,从基本概况、人员和病情分类情况、审批、费用补偿规定、报销相关手续等方面对河北省11个地级市以及省直职工异地就医相关政策进行梳理,并通过统计数据描述异地就医的现状。结合统计数据和相关文献,从政策法规、地理位置、医疗技术水平等方面对河北省各统筹区的异地就医做影响因素分析,并且分析异地就医管理中存在的问题,对河北省的异地就医管理提出相关建议:提高异地就医政策信息透明度;规范异地转诊审批程序;统一异地转诊限制范围标准;加快异地就医即时结算;简化结算所需资料;缩小异地就医与本地待遇差异。
[Abstract]:Since the reform and opening up, the rapid development of China's social economy has promoted the mobility of labor force, and cross-regional employment has become the norm. The overall level of medical insurance in China is still not high, and the regional medical insurance policy is not completely consistent. The difference of medical insurance policy between different regions and different regions makes the management of seeking medical care in different places become the difficult point of the current medical insurance work, and this problem deserves to be studied. This research adopts the methods of literature research, content analysis and comparative analysis. Firstly, the present situation of domestic and foreign research and the research scheme of this paper are expounded, and then the relevant policies and norms of the management of medical treatment in different places in Hebei Province are introduced, and the basic situation is introduced. Personnel and disease classification, examination and approval, expense compensation regulations, reimbursement procedures and other aspects of Hebei Province 11 prefectural cities and provincial workers in different areas of medical treatment related policies were combed, and through statistical data described the status quo of medical treatment in different places. Based on the statistical data and related documents, this paper analyzes the influencing factors of different places in Hebei Province from the aspects of policies and regulations, geographical location, medical technical level, and analyzes the problems existing in the management of medical treatment in different places. Some suggestions are put forward to the management of medical treatment in different places in Hebei province: to improve the transparency of the policy information of medical treatment in different places; to standardize the procedure of examination and approval of referral in different places; to unify the standard of limit range of referral in different places; to speed up the instant settlement of medical treatment in different places; to simplify the information needed for settlement; Reduce the difference between medical treatment and local treatment.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1;F842.684

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