摘要
异地就医是指基本医疗保险的参保人员在基本医疗保险统筹地区之外就医后在统筹地区申请报销相关医疗费用的行为。它的产生源于基本医疗保险统筹层次过低、医疗卫生资源配置失衡、人口流动增加和居民对健康的重视。目前异地就医管理存在异地就医费用结算滞后、异地就医政策和统筹地就医政策不统一、异地就医过度医疗服务道德风险严重、异地就医管理实施成本高和异地就医引起就医地医院之间的不正当竞争等问题。国家应重视基本医疗保障中的异地就医管理,分步骤,有重点,抓好关键环节来完善异地就医管理。
Seeing a doctor beyond the pooling district refers to the behavior that the insured of the basic medical insurance applied to withdraw the medical fees after seeing a doctor beyond the pooling district, which originates from the too low pooling of basic medical insurance, the disorder of allocation of medical resource, the increasing population migration and the more attention to health from the viewpoint of citizens. At present, there are four problems in the administration of seeing a doctor beyond the pooling district, which are the lagged fees withdrawing, the different policy between seeing a doctor beyond the pooling district and seeing a doctor in the pooling district, the high administrative cost and the illegitimate competition among the hospitals beyond the pooling district. The state should pay more attention to the administration of seeing a doctor beyond the pooling district and improve this issue step by step mainly and crucially.
出处
《中国卫生经济》
北大核心
2011年第6期15-17,共3页
Chinese Health Economics
基金
2009年教育部人文社会科学一般研究项目(09YJC840004)--城镇居民基本医疗保险适度筹资水平研究阶段性成果
关键词
基本医疗保险
异地就医
管理服务
basic medical insurance
seeing a doctor beyond the pooling district
administration service
