摘要
医疗和医保体系的良性互动对于推进医药卫生体制改革具有重要意义。由于两者之间关系的复杂性,很难使用单一的理论方法进行全面解释。作者应用系统论、博弈论、协同论对医疗与医保体系的相互关系进行分析,进而提出优化医疗和医保联动改革的政策建议,包括优化卫生资源配置、加快医保立法和卫生技术评估体系建设、加强多层次医保体系建设、推进跨区域医疗与医保信息互联互通以及完善医疗与医保协作机制、谈判机制和激励约束机制等,以更好地推动"三医"联动改革,推进健康中国建设。
The positive interaction between medical treatment system and medical insurance system is of great significance to promote the reform of medical and health care system.Due to the complexity of the relationship between them,it is difficult to explain it comprehensively with a single theoretical method.The authors analyzed the relationship between medical treatment system and medical insurance system by applying system theory,game theory and synergy theory,and then put forward policy suggestions to optimize the linkage reform of medical treatment system and medical insurance system,so as to better promote the reform of"three medical linkage"and promote the construction of healthy China.The suggestions included optimizing the allocation of health resources,accelerating the construction of medical insurance legislation and health technical evaluation system,strengthening the construction of multi-level medical insurance system,promoting the inter regional information interconnection between medical care and medical insurance,improving the coordination mechanism,negotiation mechanism,incentive and constraint mechanism between medical care and medical insurance.
作者
鲍玉荣
英立平
唐斯斯
鲍颖慧
姜琳琳
朱士俊
Bao Yurong;Ying Liping;Tang Sisi;Bao Yinghui;Jiang Linlin;Zhu Shijun(Department of Quality Management,Second Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Beijing Hospital Association,Beijing 100053,China;Smart City Development Research Center,National Information Center,Beijing 100045,China;School of Health Management,Southern Medical University,Guangzhou 510515,China;Department of Foreign Language Teaching and Research,Graduate School of Chinese PLA General Hospital,Beijing 100853,China)
出处
《中华医院管理杂志》
CSCD
北大核心
2021年第8期627-630,共4页
Chinese Journal of Hospital Administration
关键词
部门间关系
医疗体系
医保体系
联动
改革
Interdepartmental relations
Medical treatment system
Medical insurance system
Linkage
Reform
