台湾地区二代健保改革对大陆医保基金公平性及可持续性的启示

发布时间：2018-05-29 00:07

  本文选题：二代健保 + 量能付费　； 参考：《中国卫生政策研究》2017年02期

【摘要】：本文对我国台湾地区二代全民健保的改革背景、筹资和支付机制方面的改革措施进行分析。结果发现,二代健保通过调整费率,增收补充保费,扩充筹资来源,采用多元支付方式和辅助手段控制医药费用的增长,明确给付项目及标准,新增卫生技术评估作为决策依据等手段,极大缓解了财务赤字,目前已重新实现财务平衡。其多元的筹资方式、总额控费和按病种付费相结合的支付制度和为医疗质量和医保报销项目制定的评价标准等都值得大陆地区借鉴。
[Abstract]:This paper analyzes the reform background, financing and payment mechanism of the second generation national health insurance in Taiwan. The results show that the second generation health insurance system controls the growth of medical expenses by adjusting the rates, increasing the premium, expanding the sources of financing, controlling the growth of medical expenses by means of multiple payment methods and auxiliary means, and defining the items and standards of payment. New assessment of health technology as a basis for decision-making has greatly alleviated the financial deficit, and has now rebalanced the financial system. The multiple ways of raising funds, the payment system based on the combination of total fee control and disease payment, and the evaluation criteria for medical quality and medical insurance reimbursement project are all worthy of reference in mainland China.
【作者单位】： 中国药科大学国际医药商学院;
【分类号】：R197.1;F842.684
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本文编号：1948722