摘要
我国以公立医疗机构为主、以“政府补贴+基本医保基金支付+患者付费”为主要资金来源的医疗服务供给模式,产生了具有中国特色的“医疗、医保、医药”利益相关协调困境与医疗服务改革难题。而“三医协同”数字化转型正在通过医疗机构虚拟化服务场景的拓展、医保支付与监管的标准化智能化、医疗医药数据的再生产再创造等路径,推进构建“数字化+新型政产学研医”多维动力协同机制。为此,本文分别对“医疗机构+互联网医疗”、“医保支付与监管”、“医药使用与研发网络”等数字化转型场景进行“数字化+效率”的审视和反思,进而从数字治理结构与数字规则,以及数字化转型的新价值、新理念、新标准、新标杆等层面探讨“三医协同”的优化路径。
The coordination of interests among"medical care,medical insurance,and pharmaceuticals""is a difficult problem in reform of medical services with Chinese characteristics.Digital transformation of"medical service and basic insurance and drug management synergy"is promoting digital empowerment of"digitalization+new government-industry-university-research medicine"through expansion of virtualized service scenarios of medical institutions,standardization and intelligence of medical insurance payment and supervision,and paths of reproduction and re creation of medical and pharmaceutical data.This paper examines and reflects on digital transformation scenarios of"medical institutions+Internet medical care",medical insurance payment and supervision,and pharmaceutical use and research and development respectively,and then explores the optimization path of"digitalization+public value"from the perspectives of the digital governance structure and digital charter of the"medical service and basic insurance and drug management synergy",as well as new standards,new benchmarks,new values,and new concepts and other levels of digital transformation.
作者
高红
管仲军
Gao Hong;Guan Zhongjun(Government Administration College,Heilongjiang University,Harbin 150080;School of Public Health,Capital Medical University,Beijing 100069)
出处
《中国行政管理》
北大核心
2025年第1期42-48,共7页
Chinese Public Administration
基金
国家社会科学基金一般项目“公益类事业单位国有资产使用效益优化的监管机制研究”(编号:19BZZ093)
2024年度首都卫生发展科研专项项目“基于“情景-任务-能力”视域下北京市公立医院重大传染病疫情卫生应急应对能力提升研究”(编号:首发2024-1G-2013)。
关键词
三医协同
数字化转型
公共服务
数据治理
medical service and basic insurance and drug management synergy
digital transformation
public service
data governance
