摘要
介绍了福建省建瓯市以床日支付和诊次支付为主的医保支付方式综合改革，建立了覆盖市内所有定点医疗机构和所有住院门诊病种“两个全覆盖”的新模式。新的医保支付模式围绕群众健康保障为核心，促进医疗机构从逐利创收转向控制成本。在合理控制医药费用的同时，促进定点医院提高医疗服务质量及服务效率，减轻了患者看病就医的费用负担，取得多方共赢的成效。
This paper introduced the comprehensive reform of the medical insurance payment practice, featuring day/bed payment and clinical visits payment, in Jian＇ou city of Fujian province. This reform established a new pattern of ＂two full coverage＂ , i. e. , covering all designated medical institutions and all outpatient/inpatient diseases within the city. Centering on population healtheare, such a payment practice encourages changes of the medical institutions, namely to shift from profit drivers to cost control. It also pushes the designated hospitals to improve their quality of care and service efficiency based on a rational limit of medical expenses. These measures have lessened the financial burden of patients, achieving a win- win outcome.
出处
《中华医院管理杂志》
CSCD
北大核心
2017年第10期731-733,共3页
Chinese Journal of Hospital Administration
基金
国家卫生与计划生育委员会基层卫生司委托课题（2016-2018）
关键词
医保支付方式改革
基层管理
床日支付
诊次支付
Medical insurance payment reform
Primary management
Day/bed payment
Clinical visit payment
