摘要
了解美国联邦医疗保险对毕业后医学教育的投入机制,为我国下一步建立稳定的住院医师规范化培训投入机制提供参考。通过文献综述,对美国毕业后医学教育经费来源和美国联邦医疗保险资助毕业后医学教育的政策演变、经费补助方式、成本分析、面临的挑战等进行了详细分析。美国联邦政府是毕业后医学教育最主要的资金提供者,其中大部分资金来自联邦医疗保险。联邦医疗保险通过复杂的公式计算,从两个方面对住院医师规范化培训进行经费补助:直接和间接医疗费用,每年补助近100亿美元。我国应完善住院医师规范化培训补助机制,在保持目前的投入基础上,探索由医疗保险向培训医院支付更高比例的医疗费,以间接弥补医院对住培工作的投入,确保培训工作健康、可持续发展。
This study aimed to understand the investment mechanism of the US medical insurance in post-graduate medical education,and hope to provide reference for the establishment of a stable investment mechanism for residency training in China.In this article,literature review was conducted,and the investment mechanism in the USA was systematically described in several aspects including Policy evolution,subsidy methods,cost analysis and challenges.The US federal government is the largest provider of postgraduate medical education,most of the funds come from medical insurance.After a series of policy adjustments,medical insurances provide direct subsidy for teaching hospitals and indirect subsidy linked to Diagnosis Related Groups(DRGs)payment through a complicated calculation formula,and subsidize nearly 10 billion US dollars per year.On the basis of maintaining the current financial investment,China should explore methods to link the residency training subsidy to DRGs payment and make the medical insurance pay a higher proportion of medical expenses to the teaching hospitals.The extra subsidy will indirectly make up for the hospital’s investment in residency training and ensure the healthy and sustainable development of residency training.
作者
李颖
甘继瑞
高鹏
LI Ying;GAN Jirui;GAO Peng(China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中国毕业后医学教育》
2019年第6期559-562,共4页
Chinese Journal of Graduate Medical Education
基金
中日友好医院院级科研基金资助项目(2018-2-JX-3)。
关键词
住院医师规范化培训
投入机制
医疗保险
疾病诊断组
Standardized residency training
Investment mechanism
Medical Insurance
Diagnosis Related Groups
