引用本文: 牛亚冬,张亮,张翔,等.农村地区以住院服务纵向整合为导向的医保支付方式设计*[J].中国卫生经济,2023,42(5):50-53.[点击复制] NIU Ya-dong,ZHANG Liang,ZHANG Xiang,et al.The Design Method of Medical Insurance Payment Oriented by Vertical Integration of Inpatient Services in Rural Areas[J].CHINESE HEALTH ECONOMICS,2023,42(5):50-53.[点击复制]
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农村地区以住院服务纵向整合为导向的医保支付方式设计*
牛亚冬,张亮,张翔,吴建,苗豫东
0
(华中科技大学同济医学院医药卫生管理学院武汉 430030 ;湖北省人文社科重点研究基地农村健康服务研究中心武汉 430030;武汉大学政治与公共管理学院 武汉 430072 4.郑州大学公共卫生学院 郑州 450001)
摘要:
增强县乡两级医疗机构分工协作,实现县乡两级医疗机构的功能互补和服务连续,对于农村地区分级有序就医格局的形成至关重要。以此为目标,提出了县乡跨机构按病种支付方式,并从病种选择、连续性服务路径、支付标准、分配方案等方面进行了设计,从机构收益、患者自付、医保支出等方面对其潜在效果进行了分析。
关键词:  农村  连续性医疗服务  医保支付方式改革  卫生服务整合
DOI:
投稿时间:2023-02-06
基金项目:国家自然科学基金项目( 716730 99) ;教育部哲学社会科学研究重大课题攻关项目(18JZD044)
The Design Method of Medical Insurance Payment Oriented by Vertical Integration of Inpatient Services in Rural Areas
NIU Ya-dong,ZHANG Liang,ZHANG Xiang,WU Jian,MIAO Yv-dong
()
Abstract:
Strengthening the cooperation,and realizing the functional complementation and continuous service of medical institutions at county and township levels between medical institutions at county and township levels are crucial to tiered medical services in rural areas. It proposed the payment by disease for services between county and township medical institutions. The aspects of disease type selection,continuous service path,and payment standard and distribution scheme are designed to analyze its potential effects from the aspects of institutional income,out of pocket expenses,and health insurance expenditure.
Key words:  rural area  ontinuous service  health insurance payment  health service integration

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