医疗保险对中医药发展的影响及对策分析

发布时间：2018-06-01 01:21

本文选题：中医药 + 医疗保险　；参考：《世界科学技术-中医药现代化》2013年08期

【摘要】：目的:本研究基于课题前期专家咨询和文献查阅,旨在从定点医疗机构中医医师的视角,进一步分析医疗保险对中医药发展产生的影响,并提出具体建议,以促进中医药与医疗保险的良性发展。方法:采用问卷调查的方法,对全国253名医疗保险定点医疗机构中医医师在中医药和医疗保险关联方面的看法进行调查研究,使用频数统计等方法对数据进行处理。结果:医保定点后参保患者已成为医院的主要服务人群(73.5%),医院(68.4%)和中医师(41.9%)的收入均有所增长,有助于中医医院做大做强(63.6%);参保患者主要因疗效(37.9%)和安全(24.1%)而选择中医药治疗,医保报销比例的影响较低(1.2%);中医药医保报销范围需进一步扩大,如中药院内制剂(90.5%)和代煎费(78.3%)等。结论:在"全民医保"背景下,医疗保险对中医药发展影响越来越大,中医药应通过标准化等手段保障安全和提高疗效,同时医疗保障政策和医疗保险管理服务标准的制定也需考虑中医药的特性,鼓励提供中医药服务。
[Abstract]:Objective: This study is based on the expert consultation and literature review on the basis of the prophase of the subject. The purpose of this study is to further analyze the impact of medical insurance on the development of traditional Chinese medicine from the perspective of doctors of traditional Chinese medicine in designated medical institutions, and to put forward specific suggestions in order to promote the benign development of traditional Chinese medicine and medical insurance. Method: the method of questionnaire investigation is adopted to 253 medical care in the country. The doctors of medical institutions of insurance fixed-point medical institutions have investigated the views of traditional Chinese medicine and medical insurance, and use the methods of frequency statistics to deal with the data. Results: after medical insurance, the insured patients have become the main service population of the hospital (73.5%). The income of the hospital (68.4%) and the traditional Chinese Medicine Division (41.9%) has increased, which is helpful. Medical hospital is big and strong (63.6%); the insured patients mainly choose traditional Chinese medicine for curative effect (37.9%) and safety (24.1%), and the proportion of medical insurance reimbursement is lower (1.2%); the scope of medical insurance reimbursement for traditional Chinese medicine should be further expanded, such as traditional Chinese medicine (90.5%) and generation Decoction (78.3%). The development of traditional Chinese medicine should ensure safety and improve the curative effect by means of standardization. At the same time, the formulation of medical insurance policy and medical insurance management service standards should also consider the characteristics of traditional Chinese medicine and encourage the provision of traditional Chinese medicine service.
【作者单位】：中国中医科学院中医临床基础医学研究所;
【基金】：国家质量监督检验检疫总局公益性行业科研专项标准化项目(201110241-3):医疗和生育保险管理服务标准研究(中医药部分),负责人:韩学杰
【分类号】：F842.6;F426.72

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