摘要
目的:为完善定点零售药店纳入门诊统筹管理政策提供依据。方法:基于利益相关者理论,结合文献综述、定性访谈分析定点零售药店纳入门诊统筹管理政策的实施对利益相关者的影响。结果:理想层面,定点零售药店纳入门诊统筹管理政策的顺利实施能够缓解职工医保个人账户改革所带来的冲击,缓解医疗机构就诊压力,提升参保人购药的便利性。然而,受制于政策设计不完善、配套措施跟进不及时等因素,短期内政策产生的实际效果与理想状态存在差异。讨论和建议:医保部门持续收集政策实施的相关反馈,不断优化政策设计;完善政策时以参保人为核心,兼顾多方主体利益;充分了解相关主体的特点和利益关系,强化医保基金监管。
Objective:To provide ideas and basis for the improvement of incorporating designated retail pharmacies into outpatient insurance pooling fund management policies.Method:Based on stakeholder theory,combined with literature review and interview research,qualitative analysis was conducted on the impact of the implementation of incorporating pharmacies into outpatient insurance pooling fund management policies on relevant stakeholders.Results:From an ideal perspective,the successfully implementation of the policy of incorporating pharmacies into outpatient insurance pooling fund management can alleviate the impact of individual account reform in employee medical insurance,alleviate the pressure of medical institutions,and improve the convenience of insured individuals in purchasing medicine.However,due to factors such as incomplete policy design and untimely follow-up of supporting measures,the actual impact of policies in short term differs from ideal.Discussions and Suggestions:To assist in policy improvement,it is recommended that the medical insurance department continue to collect feedback on policy implementation and continuously optimize policies;Improve policies with insured individuals at the core,taking into account the interests of multiple stakeholders;Fully understand the characteristics and interests of relevant parties,and strengthen the supervision of medical insurance funds.
作者
丁瑞琳
颜建周
欧阳沁
李馨雨
邵蓉
DING Rui-lin;YAN Jian-zhou;OUYANG Qin;LI Xin-yu;SHAO Rong(Research Center of National Drug Policy&Ecosystem,China Pharmaceutical University,Nanjing Jiangsu 211198,China)
出处
《中国卫生政策研究》
CSCD
北大核心
2024年第3期17-23,共7页
Chinese Journal of Health Policy
关键词
定点零售药店
门诊统筹
利益相关者
影响
Designated retail pharmacy
Outpatient pooling
Stakeholders
Impact
