[1]李国瑜,姚 强,刘小君,等.我国“互联网+”医疗服务医保支付政策研究[J].卫生经济研究,2023,40(5):43-46.
 LI Guoyu,YAO Qiang,LIU Xiaojun,et al.Research on Medical Insurance Payment Policy of "Internet Plus" Medical Service in China[J].Journal Press of Health Economics Research,2023,40(5):43-46.
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我国“互联网+”医疗服务医保支付政策研究
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
40
期数:
2023年5期
页码:
43-46
栏目:
医疗保障
出版日期:
2023-05-05

文章信息/Info

Title:
Research on Medical Insurance Payment Policy of "Internet Plus" Medical Service in China
作者:
李国瑜1姚 强2刘小君1彭昱欣1刘雨鑫1夏佳贝1张之恒2刘智勇1
1.华中科技大学同济医学院医药卫生管理学院,湖北 武汉 430030
2.武汉大学政治与公共管理学院,湖北 武汉 430030
Author(s):
LI Guoyu YAO Qiang LIU Xiaojun PENG Yuxin LIU Yuxin XIA Jiabei ZHANG Zhiheng LIU Zhiyong
School of Medicine and Health Management, Tongji Medical Collage of Huazhong University of Science & Technology, Wuhan Hubei 430000, China
关键词:
“互联网+”医疗服务医保支付价格项目
Keywords:
"Internet Plus" medical service medical insurance payment project and price management
分类号:
R19
文献标志码:
A
摘要:
目的:分析各省(区、市)“互联网+”医疗服务的医保支付现状,为后续政策制定提供参考。方法:采用内容分析法和聚类分析法,从“互联网+”医疗服务项目开展情况、医保支付情况以及二者的结合情况,探究“互联网+”医疗服务的发展现状。结果:各省(区、市)“互联网+”医疗服务项目、医保协议和经办管理情况存在较大差异,虽然医保支付覆盖总体情况较好,但限制条件较多;根据项目开展数量和医保覆盖水平,将各省(区、市)“互联网+”医疗服务医保支付情况聚类为四种类型,并分类提出发展建议。结论:规范“互联网+”医疗服务项目申报审批流程,形成价格项目管理体系,加强医保支付管理,鼓励创新。
Abstract:
Objective To analyze the current situation of medical insurance payment for "Internet plus" medical services in various provinces (autonomous regions and municipalities), and to provide reference for subsequent policy. Methods Content analysis and cluster analysis were used to explore the development status of "Internet plus" medical services from the implementation of "Internet plus" medical services and medical insurance payment. Results There are quite different in the medical service items, medical insurance agreements and handling management of "Internet plus" in different provinces (autonomous regions and municipalities). Although the overall coverage of medical insurance payment is good, there are many restrictions. According to the number of projects carried out and the level of medical insurance coverage, the medical insurance payment of "Internet plus" medical services is classified into four types, and development suggestions are proposed. Conclusion We should standardize the application and approval process of "Internet plus" medical service items, form a price management system, strengthen the management of medical insurance payment, and encourage innovation.

参考文献/References:

[1] 郑大喜,聂丽丽,王莉燕,等. “互联网+医疗”背景下的医保管理[J].中国医院,2021,25(6):5-8.
[2] 郭珉江,李亚子,张芳源,等.平台经济学视角下“互联网+”医保支付参与机制的探讨[J].中国卫生经济,2020,39(1):30-33.
[3] 吴义天,杨燕绥.荷兰基层互联网医疗的发展经验及启示[J]. 卫生经济研究,2021,38(4):39-42.
[4] 谭清立,陈嘉琳,庄洲洲.我国“互联网+”医疗的政策推进与优化研究——基于政策文本量化分析[J].卫生经济研究,2021,38(7): 21-23.
[5] 葛鹏楠,赵雨,韩彩欣.互联网医疗政策的执行问题和对策——基于史密斯模型的分析[J].卫生经济研究,2021,38(1):17-21.
[6] 袁吉,肖煜吟,施贞夙,等.互联网医疗更好地满足慢病患者就医需求的分析和思考[J].中国医院,2021,25(8):44-47.
[7] 魏倩如,李红艳,朱敏.互联网医疗下公立医院以患者为中心的改革实践[J].中国医院,2021,25(6):29-31.
[8] 王震. “互联网+”医疗服务纳入医保监管体系的建议[J]. 中国卫生信息管理杂志,2021,18(5):589-592.619.
[9] 张瑞利,王刚. “互联网”医疗服务供给:模式比较及优化路径[J].卫生经济研究,2022,39(3):32-37.
[10] 许航,王玙珩,马晓静.我国“互联网+”医疗服务价格管理现状与对策研究[J].中国卫生经济,2020,39(12):48-51.
[11] 路娜娜,徐伟,杜雯雯,等.美国互联网医疗服务的医保支付政策及启示[J].卫生经济研究,2020,37(10):37-41.
[12] 崔文彬,张焜琨,顾松涛,等. “互联网+”医疗服务纳入医保支付范围研究[J].中国医院,2020,24(3):4-6.
[13] 曹俊山,许宏,吕大伟.医疗保障部门应对新型冠状病毒肺炎疫情的策略及经验[J].中国卫生资源,2021,24(6):700-704.
[14] 杨红燕.数字化时代的数字医保:内涵、价值、挑战与治理思路[J].华中科技大学学报(社会科学版),2021,35(2):17-24.
[15] 申曙光,吴庆艳.健康治理视角下的数字健康:内涵、价值及应用[J].改革,2020(12):132-144.
[16] 路娜娜,徐伟,杜雯雯,等.美国互联网医疗服务的医保支付政策及启示[J].卫生经济研究,2020,37(10):37-41.
[17] 常欢欢,于丽华.我国新增医疗服务价格项目管理现状的研究与思考[J].中国医院管理,2017,37(10):33-35.
[18] 李亚青.医疗保障对健康平等的影响机制和精准化改进路径[J].社会保障评论,2022,6(2):59-73.
[19] 吴迪,计晓伟.互联网医疗产业的运行逻辑与高质量发展[J]. 改革,2021(6):125-135.
[20] 于保荣,杨瑾,宫习飞,等.中国互联网医疗的发展历程、商业模式及宏观影响因素[J].山东大学学报(医学版),2019,57(8):39-52.

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 JIA Hongbo,LU Jiaqian.Challenges and Countermeasures of Basic Medical Insurance Payment in "Internet Plus" Medical Services[J].Journal Press of Health Economics Research,2023,40(5):54.

更新日期/Last Update: 2023-05-05