湖南省医保支付方式选择研究

发布时间：2018-06-01 17:30

本文选题：医疗保险 + 支付方式　；参考：《中南大学》2014年硕士论文

【摘要】：在我国,医疗费用面临着快速上涨的趋势,医疗保险制度的稳定运行受到医疗费用增长的严重威胁。在医疗保险制度的运行过程中,医疗保险支付是其中第二大重要环节,而且是非常关键的一个环节。保障医疗保险制度平稳运行和可持续发展的关键基础是医疗保险基金的支付管理,医疗保险管理工作的另外一个重点是防范支付过程带来的风险。深入的研究医疗保险支付方式,对各种支付方式的实际运作效果和利弊得失进行分析,对于防范在医疗保险支付过程中出现风险、有效的对医药费用进行控制、满足参保者的实际和基本的医疗需求、并保证医疗制度的平稳性是非常重要的。本研究在探讨我国医疗保险发展过程的基础上,采用博弈模型分析的方法探讨湖南省医疗保险支付方式的选择问题。另外,本研究还提出了在探讨医疗保险支付方式时应当展开研究的外部环境因素,这些外部环境因素主要包括人文环境和经济环境,目的在于对供方进行管理强化,对供方能够提供更为优质的服务起到引导的作用,为支付方式提供根据情况的动态变化进行调整以及进行精细化、多样化管理的建议和对策,促进其加强创新。
[Abstract]:In our country, the medical cost is rising rapidly, and the steady operation of the medical insurance system is seriously threatened by the increase of the medical cost. In the running process of medical insurance system, medical insurance payment is the second important link, and is a very key link. The key to ensure the smooth operation and sustainable development of the medical insurance system is the payment management of the medical insurance fund, and the other key point of the medical insurance management is to guard against the risks brought by the payment process. Deeply study the medical insurance payment method, analyze the actual operation effect, advantages and disadvantages of various payment methods, to prevent the risk in the process of medical insurance payment, and effectively control the medical expenses. It is important to meet the actual and basic medical needs of the insured and to ensure the smoothness of the health care system. On the basis of discussing the development process of medical insurance in China, this study uses the game model analysis method to discuss the choice of medical insurance payment mode in Hunan Province. In addition, this study also puts forward the external environmental factors that should be studied when discussing the payment mode of medical insurance. These external environmental factors mainly include the humanistic environment and the economic environment, in order to strengthen the management of the supplier. It can guide the supplier to provide better service and provide suggestions and countermeasures to adjust the payment mode according to the dynamic changes of the situation and to manage it finely and diversified so as to promote its innovation.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F842.684;R197.1

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