[1]贾洪波,鲁佳倩.“互联网+”医疗服务医保支付的挑战及对策[J].卫生经济研究,2023,40(6):54-56,60.
 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(6):54-56,60.
点击复制

“互联网+”医疗服务医保支付的挑战及对策
分享到:

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
40
期数:
2023年6期
页码:
54-56,60
栏目:
医疗保障
出版日期:
2023-06-05

文章信息/Info

Title:
Challenges and Countermeasures of Basic Medical Insurance Payment in "Internet Plus" Medical Services
作者:
贾洪波1鲁佳倩1
1.北京航空航天大学社会保障研究中心,北京 100191
Author(s):
JIA Hongbo LU Jiaqian
Research Center for Social Security, Beihang University, Beijing 100191, China
关键词:
“互联网+”医疗服务医保支付线上结算
Keywords:
"internet plus" medical services medical insurance payment online reimbursement
分类号:
R19
文献标志码:
A
摘要:
“互联网+”医疗服务有助于提高就医效率、节约就医成本、均衡优势医疗资源的利用、推动医药卫生体制改革。目前,我国“互联网+”医疗服务医保支付面临老年人的数字鸿沟、医保基金的收支平衡、异地就医费用的支付差异、医保电子凭证的法律认同等方面的挑战,对此需要通过相应措施,进一步推动“互联网+”医疗服务医保支付政策的落地。
Abstract:
The practice of basic medical insurance payment in "internet plus" medical services can improve medical efficiency, save medical costs, balance the use of advantageous medical resources, and promote the reform of the medical and health system. However, this practice still faces challenges such as the digital gap for the elderly, defrauding basic medical insurance fund expenditure, differences in payment of medical expenses in different places, difficulties in legal recognition of electronic vouchers of basic medical insurance. It is need to further promote the implementation of medical insurance payment policies for "internet plus" medical services through various measures.

参考文献/References:

[1] Jain T,Mehrotra A.Comparison of direct-to-consumer telemedicine visits with primary care visits[J].JAMA Netw Open,2020,3(12):e202 8392.
[2] Gaziel-Yablowitz M,Bates D W, Levine D M.Telehealth in US hospitals:State-level reimbursement policies no longer influence adoption rates[J].International Journal of Medical Informatics,2021, 153: 104540.1-104540.7.
[3] Van CittersA D,Dieni O,Scalia P,et al.Barriers and facilitators to implementing telehealth services during the COVID-19 pandemic: A qualitative analysis of interviews with cystic fibrosis care team members[J].Journal of Cystic Fibrosis,2021,20(Supp13):23-28.
[4] Mehta P,Braskett M,Tam J S,Espinoza J.Reimbursement patterns and user experiences in pediatric allergy home telehealth[J].Annals of Allergy,Asthma & Immunology,2020,125(6):693-698.
[5] 杨扬,蔡滨,史力群,等.新冠疫情背景下公立医院推进“互联网+医保服务”的实践与思考[J].现代医院,2022,22(8):1254-1256.
[6] 史莉莉.“互联网+医保”:机遇与挑战并存[J].中国社会保障,2020(5):82-83.
[7] 晏子逸.常态化疫情防控下互联网医疗面临的机遇与挑战[J].中国国情国力,2022(2):43-47.
[8] 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.
[9] 马思琦,曹阳.“互联网+医疗”纳入医保支付的相关研究及政策建议[J].现代商贸工业,2021,42(35):99-100.
[10] 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.
[11] 刘健,霍莉莉,雷凯.基于互联网诊疗模式的医保结算体系研究与应用[J].中国数字医学,2020,15(7):39-41.
[12] 黄如意,胡善菊.山东省医养结合模式发展的SWOT分析[J].中国卫生事业管理,2016,33(2):145-147.
[13] 刘欢.北京“互联网+”医保零距离服务市民[N].北京日报,2022-08-01.
[14] 张腾.互联网+医疗救助扶贫项目”让贫困患者医有所保[N].健康导报讯,2020-06-09.
[15] 邓勇,周仪昭.“互联网+”医保服务中的规制缺陷和综合治理[J].中国医院院长,2021,17(7):66-69.
[16] 贾洪波.基本医保基金经办机构与公立医院之应然关系——理论及其对公立医院改革的启示[J].北京航空航天大学学报(社会科学版),2018,31(4):44-52,59.
[17] 金春枝,李伦.我国互联网数字鸿沟空间分异格局研究[J].经济地理,2016,36(8):106-112.
[18] 金龙,代伟,马敬东.接受美学视域下老年人在线健康服务数字鸿沟应对策略研究[J].医学与社会,2022,35(5):35-38,44.
[19] 腾讯研究院.吾老之域: 老年人微信生活与家庭微信反哺[M].杭州:浙江出版集团数字传媒有限公司,2018:15-19.
[20] 张勇,杨勇鹏.福建:异地就医升级攻略[J].中国社会保障,2018(3):35.
[21] 张未平,范君晖.老年数字鸿沟的社会支持体系构建[J].老龄科学研究,2019,7(2):63-70.
[22] 陆杰华,韦晓丹.老年数字鸿沟治理的分析框架、理念及其路径选择——基于数字鸿沟与知沟理论视角[J].人口研究,2021,45(3):17-30.
[23] 詹长春,黄晶晶.协同治理视角下医保欺诈行为监管体系优化研究[J].中国卫生事业管理,2021,38(9):668-671.

相似文献/References:

[1]田文华.上海市医保支付改革方案的设计和模拟分析[J].卫生经济研究,2018,(02):22.
[2]梁 冰,王前强,陈凤磊,等.国家谈判药品对综合医院医保管理的影响及对策[J].卫生经济研究,2020,(05):42.
 LIANG Bing,WANG Qian-qiang,CHEN Feng-lei,et al.Impact of National Negotiation Drugs on Medical Insurance Management in General Hospitals and Countermeasures[J].Journal Press of Health Economics Research,2020,(6):42.
[3]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,(10):37.
 LU Na-na,XU Wei,DU Wen-wen,et al.Medical Insurance Payment Policy and Enlightenment of American Internet Medical Service[J].Journal Press of Health Economics Research,2020,(6):37.
[4]于保荣.DRG与DIP的改革实践及发展内涵[J].卫生经济研究,2021,38(1):4.
 YU Bao-rong.Reform Practice and Development Connotation of DRG and DIP[J].Journal Press of Health Economics Research,2021,38(6):4.
[5]王海银,丛鹂萱,谢春艳,等.我国创新药品医保支付改革的进展及思考[J].卫生经济研究,2021,38(1):47.
 WANG Hai-yin,CONG Li-xuan,XIE Chun-yan,et al.Progress and Consideration on the Medical Insurance Payment Reform for Innovative Drugs in China[J].Journal Press of Health Economics Research,2021,38(6):47.
[6]陈志鹏,杨金侠.医保支付促进慢性病管理的国际经验及启示[J].卫生经济研究,2021,38(2):38.
 CHEN Zhi-peng,YANG Jin-xia.International Experience and Inspiration of Medical Insurance Payment on Promoting Chronic Disease Management[J].Journal Press of Health Economics Research,2021,38(6):38.
[7]薛丽娜,王世贞,毛宗福.我国城镇职工医保的门诊统筹进展及改革思考[J].卫生经济研究,2021,38(10):30.
 XUE Li-na,WANG Shi-zhen,MAO Zong-fu.Thoughts on Outpatient Co-ordination Development and Reform of Urban Employee Medical Insurance in China[J].Journal Press of Health Economics Research,2021,38(6):30.
[8]裘凯音,王 佳,王伟红,等.市级统筹背景下DRG付费的公平性研究[J].卫生经济研究,2021,38(12):33.
 QIU Kai-yin,WANG Jia,WANG Wei-hong,et al.Research on the Fairness of DRG Payment at the Municipal Level[J].Journal Press of Health Economics Research,2021,38(6):33.
[9]陈姬雅,娄雪萍,王蓉蓉,等.数字医疗推动DRG点数支付改革的精细化管理[J].卫生经济研究,2021,38(12):72.
 CHEN Ji-ya,LOU Xue-ping,WANG Rong-rong,et al.Digital Medical Promotes Fine Management of DRG Point Payment Reform[J].Journal Press of Health Economics Research,2021,38(6):72.
[10]金春林,彭 颖,王海银.深化医疗服务价格改革的内涵与思考[J].卫生经济研究,2022,39(1):7.
 JIN Chun-lin,PENG Ying,WANG Hai-yin.The Connotation and Thinking of Deepening the Medical Service Price Reform[J].Journal Press of Health Economics Research,2022,39(6):7.
[11]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.
 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(6):43.

更新日期/Last Update: 2023-06-05