长春市定点医院医疗保险管理改进对策研究
发布时间：2018-10-12 21:20
【摘要】：随着医疗保险的逐步发展，医保的覆盖面愈来愈大，全民医保时代已悄然降临。医疗保障体系的完善，不仅是国计民生的主要内容，也是彰显社会主义优越性的重要方面。医保制度是否健全，直接影响着百姓的日常生活，乃至影响整个国家的稳定。随着我国的经济发展，医疗制度也随之逐步改革。由于其改革与百姓生活密切相关而被广泛关注，尽管在改革的过程中饱受各方面的争议，，但结果还是卓有成效，卫生事业实现了快速的发展，医疗制度也取得了广泛的认可。 本文讨论的目的在于，在系统回顾和分析国内外医疗保障制度的基础上，系统分析医、患、保三者的利益格局，探寻实现三方共赢的路径。在保证政府医疗费用支出平衡的基础上，使百姓能够享受更优质的医疗服务。 本文从医院管理者的角度,对长春市医保在解放军四六一医院运行的个案研究进行分析，深入讨论了医院在面对新的形势时，主动适应医保政策和医疗竞争的必然趋势。管理行为对医疗保险制度的改革将会产生重要的影响，医院在适应医保制度改革的同时，医疗保险制度的逐步推进和不断完善又作用于医院的可持续发展。因此，研究医院与医疗保险相辅相成、相互支持，既有依赖又有相互制约的对立统一关系，寻求两者之间的既能发展各自内涵，又能拓展各自外延的机制已是当前政府、卫生行政部门、医疗保险和医院管理者共同关注的热点。本文在研究分析医疗保险与医院的相互关系和管理行为的互补性的同时，还为今后两者协调发展提出了对策和建议，以探索适合我国国情的新型医院与医疗保险共同协调发展的途径。
[Abstract]:With the gradual development of medical insurance, the coverage of medical insurance is increasing, and the era of universal health insurance has come quietly. The perfection of medical security system is not only the main content of national economy and people's livelihood, but also the important aspect of showing the superiority of socialism. Whether the health insurance system is sound or not directly affects the daily life of the people and even the stability of the whole country. With the economic development of our country, the medical system has been reformed step by step. Because its reform is closely related to the life of the people, it has been widely concerned. Although it has been controversial in all aspects in the process of reform, the results are still fruitful, the health care has achieved rapid development, and the medical system has also been widely recognized. The purpose of this paper is to systematically analyze the benefit pattern of medical care, patient and insurance on the basis of systematic review and analysis of the medical security system at home and abroad, and to explore the way to realize the win-win situation among the three parties. On the basis of ensuring the balance of government medical expenditure, people can enjoy better medical service. From the point of view of hospital manager, this paper analyzes the case study on the operation of Changchun medical insurance in PLA 4 / 61 hospital, and discusses in depth the inevitable trend of hospital actively adapting to medical insurance policy and medical competition in the face of new situation. The management behavior will have an important influence on the reform of the medical insurance system. While the hospital adapts to the reform of the medical insurance system, the medical insurance system will be promoted and perfected step by step, and it will play an important role in the sustainable development of the hospital. Therefore, the study of hospital and medical insurance complement each other, support each other, both rely on and restrict the unity of opposites, seek the mechanism between the two can both develop their connotations and expand their respective extension of the mechanism is the current government, Health administration, medical insurance and hospital administrators are the hot spots of common concern. While studying and analyzing the relationship between medical insurance and hospitals and the complementarity of management behavior, this paper also puts forward some countermeasures and suggestions for the coordinated development of medical insurance and hospitals in the future. In order to explore a new type of hospital and medical insurance to develop in harmony.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F842.684
本文编号：2267634
[Abstract]:With the gradual development of medical insurance, the coverage of medical insurance is increasing, and the era of universal health insurance has come quietly. The perfection of medical security system is not only the main content of national economy and people's livelihood, but also the important aspect of showing the superiority of socialism. Whether the health insurance system is sound or not directly affects the daily life of the people and even the stability of the whole country. With the economic development of our country, the medical system has been reformed step by step. Because its reform is closely related to the life of the people, it has been widely concerned. Although it has been controversial in all aspects in the process of reform, the results are still fruitful, the health care has achieved rapid development, and the medical system has also been widely recognized. The purpose of this paper is to systematically analyze the benefit pattern of medical care, patient and insurance on the basis of systematic review and analysis of the medical security system at home and abroad, and to explore the way to realize the win-win situation among the three parties. On the basis of ensuring the balance of government medical expenditure, people can enjoy better medical service. From the point of view of hospital manager, this paper analyzes the case study on the operation of Changchun medical insurance in PLA 4 / 61 hospital, and discusses in depth the inevitable trend of hospital actively adapting to medical insurance policy and medical competition in the face of new situation. The management behavior will have an important influence on the reform of the medical insurance system. While the hospital adapts to the reform of the medical insurance system, the medical insurance system will be promoted and perfected step by step, and it will play an important role in the sustainable development of the hospital. Therefore, the study of hospital and medical insurance complement each other, support each other, both rely on and restrict the unity of opposites, seek the mechanism between the two can both develop their connotations and expand their respective extension of the mechanism is the current government, Health administration, medical insurance and hospital administrators are the hot spots of common concern. While studying and analyzing the relationship between medical insurance and hospitals and the complementarity of management behavior, this paper also puts forward some countermeasures and suggestions for the coordinated development of medical insurance and hospitals in the future. In order to explore a new type of hospital and medical insurance to develop in harmony.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F842.684
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