| 引用本文: |
潘庆霞,吴群红,郝艳华,等.医保制度运行的关键节点问题综合评价研究[J].中国卫生经济,2017,(7):28-30.[点击复制] |
.Comprehensive Evaluation of the Key Nodes on the Implementation of Health Care System[J].CHINESE HEALTH ECONOMICS,2017,(7):28-30.[点击复制] |
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| 摘要: |
| 目的:明确医保制度运行的突出问题，分析问题背后深层次的根源，为政策制定者提供决策的依据。方法：运用文献研究、现场调查和专家小组的方法进行问卷的调查，并采用TOPSIS综合评价法对我国医保制度运行的问题进行综合评价。结果：我国医保制度运行的6大突出问题排序为基金筹集相关问题(Ci=0.722)、基金运行和管理(Ci=0.634)、经济保护能力(Ci=0.471)、监督运行机制(Ci=0.388)、卫生服务利用公平性(Ci=0.374)和管理制度问题(Ci=0.347)。结论：研究结果显示医保基金缺乏合理的筹资机制和稳定的经费来源及制度的区域差异、运行中基金的收支不平衡导致的矛盾问题以及各险种账户管理政策不一等、低收入高危弱势人群灾难性卫生支出发生率仍较高等是医保制度运行过程中的突出问题。因此大力推进城乡居民的医保制度筹资机制，实现从定额筹资到按可支配收入为基数筹资的过渡，通过控制医疗费用不合理的增长来保障基金的收支平衡，提高医保的统筹层次以及大病医保政策的有效推动等一揽子方案是医保制度运行问题的根本解决措施。 |
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| Comprehensive Evaluation of the Key Nodes on the Implementation of Health Care System |
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| Abstract: |
| Objective: To identify the key problems of the health care system implementation and to analysis the problems, and provide decision making for policy administrators. Methods: Literature research, field survey and expert panel method of questionnaire survey were used in the study, TOPSIS comprehensive evaluation method was used for multidimensional comprehensive evaluation of the key problems in health care system implementation. Results: Ranking problems were fund raising, fund implementation and management, the ability of economic protection, supervision and the utilization of health service equity and management system. Conclusions: The results show that lack the reasonable financing mechanism, stable fund source and the regional difference of the system, contradictions in the implementation of the fund’’s balance of payments and the various types of account management policies, the incidence of catastrophic health expenditure are still prominent problems in the implementation of the health care system. So promoting the medical insurance system of urban and rural residents financing mechanisms, from fixed financing to transition in disposable income as the base of financing, controlling the unreasonable growth of medical expenses to ensure the fund’’s balance of payments, improving the overall level of health insurance and the effective promotion of serious illness insurance policy are the fundamental solutions to the problem of the health care system. |
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