江苏省十三个地级市城镇职工医疗保险单病种付费实施现状
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1东南大学附属第二医院 南京市第二医院 江苏南京 210003

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Situation of the Implementation of Medical Insurance System for Urban Workers in Jiangsu Province CHEN Lei .The Second Affiliated Hospital with Southeast University, The Second Hospital of Nanjing, Nanjing 210003,China
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The Second Affiliated Hospital with Southeast University, The Second Hospital of Nanjing,

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    摘要:

    摘要:(目的)了解江苏省十三个地级市单病种付费实施现状,(方法)通过定量调查、宏观政策分析法、定性访谈法分析。(结果)了解目前十三个地级市的单病种付费按照支付方式的不同可分为定额支付、限额支付以及定额与限额支付相结合三种不同类型,(讨论)整体上单病种付费控制不合理医疗费用效果尚不明显,参保人接受程度较高,保方认为有利于强化医保收支预算,院方认为施过程细节需要完善、配套政策需加强。

    Abstract:

    (Objectives) To understand the status quo of payment for single diseases of thirteen cities in Jiangsu Province. (Methods) Through quantitative survey, macro-policy analysis and qualitative interview analysis.?(Results) The results show that in the 13cities, the payment of single diseases can be divided into fixed payment, limit payment and combination of fixed quota and limit payment according to different payment methods. (Discussion) As a whole, Payment?Control unreasonable medical costs effect is not obvious, the insured person is highly accepted, the insurance policy that is conducive to strengthening health care revenue and expenditure budget, the hospital think that the details of the process need to be improved, supporting policies need to be strengthened.

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  • 收稿日期:2017-08-08
  • 最后修改日期:2017-12-12
  • 录用日期:2018-02-22
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