甘肃省城镇居民基本医保门诊统筹支付方式的选择

发布时间：2019-06-04 00:06

【摘要】：随着经济的发展和医保筹资能力的不断提高,门诊统筹逐步开展起来。但是医疗费用过快增长,一直是困扰老百姓的一大难题。随着人口老龄化的加剧,人民群众的医疗需求变得多元化和多样化,医疗费用的增长呈现过快趋势。这些对医疗保险基金的支付造成了很大的挑战。医疗保险基金支付方式的选择和完善成为政府关注的重点,并且其改革也成为医疗改革的关键政策措施。合理的支付方式可以有效地控制医疗服务费用的过快增加,优化医疗资源的配置,体现医疗服务的公平性,真正满足参保者必需的医疗需求。通过对甘肃省城镇居民基本医疗保险门诊统筹实施情况的分析,比较新农合和住院统筹模式,以及目前常用的支付方式的优缺点,结合甘肃省的实际,对甘肃省门诊统筹支付方式的选择提出建议。
[Abstract]:With the development of economy and the continuous improvement of medical insurance financing ability, outpatient planning is gradually carried out. However, the rapid growth of medical expenses has always been a major problem for ordinary people. With the aggravation of the aging population, the medical demand of the people has become diversified and diversified, and the growth of medical expenses has shown a rapid trend. These pose a great challenge to the payment of health insurance funds. The choice and improvement of payment mode of medical insurance fund has become the focus of government attention, and its reform has also become the key policy measure of medical reform. Reasonable payment method can effectively control the excessive increase of medical service costs, optimize the allocation of medical resources, reflect the fairness of medical services, and truly meet the necessary medical needs of insured people. Through the analysis of the overall implementation of the basic medical insurance clinic for urban residents in Gansu Province, this paper compares the new rural cooperative and hospitalization overall planning models, as well as the advantages and disadvantages of the current commonly used payment methods, combined with the actual situation in Gansu Province. This paper puts forward some suggestions on the choice of the overall payment method of outpatient department in Gansu Province.
【作者单位】：甘肃农业大学人文学院;
【基金】：甘肃省医疗保险研究会资助项目(2011-2012)
【分类号】：F842.6

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