摘要
为推动分级诊疗制度,建立分工协作的医疗服务体系,南京市基本医疗保险实行差异化支付政策,努力打造"大病进医院,小病进社区"的医疗保险就诊服务模式,分级诊疗初见成效,常见病、慢性病向基层就医趋势明显,重大疾病在三级医院就医比例稳中有升。但对于不限病种的门诊统筹,患者仍集中于三级医院,未取得向基层医院转移的效果。本文针对政策实施中存在的问题,提出重视人才和技术、健全药品保障机制、规范双向转诊标准,促进医生多点执业,实现信息共享和提高决策能力等建议。
In order to promote the building of classified diagnosis and treatment system, and the establishment a divided and cooperative medical service mechanism, differentiated payment policies in Nanjing has been implemented. The goal of this policy is to create a medical service model of ＂visiting hospitals if having serious diseases, visiting community clinics if having minor illness＂. The effect of disease classification（chronic or serious） in outpatient department has been achieved. The patients with chronic diseases tended to visit primary hospitals, and the patients with serious illnesses tend to visit high level hospitals. However, if there were no limitation for specific diseases, the patients would like to visit 3-A level hospitals, even though the rate of reimbursement for primary hospital is higher. To solve above problems, this article makes suggestions on putting high value on improving doctors＇ ability and technology, improving the drug supply mechanism, establishing two-way transfer standards, promoting doctors multi-sited practicing, sharing medical information and increasing the abilities of decisionmaking.
出处
《中国医疗保险》
2015年第6期41-44,48,共5页
China Health Insurance
关键词
分级诊疗
支付政策
医疗费用
对策
classifi ed diagnosis and treatment
payment policy
medical cost
countermeasures
