[1]童禧辰,张璐莹,李凯渊,等.国内外“互联网+”医疗服务医保支付比较研究[J].卫生经济研究,2025,42(09):39-42.
　TONG Xichen,ZHANG Luying,LI Kaiyuan,et al.Comparison of the Domestic and International Medical Insurance Payment for "Internet+" Medical Services[J].Journal Press of Health Economics Research,2025,42(09):39-42.
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国内外“互联网+”医疗服务医保支付比较研究

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
42
期数:
2025年09期
页码:
39-42
栏目:
他山之石
出版日期:
2025-08-28

文章信息/Info

Title:
Comparison of the Domestic and International Medical Insurance Payment for "Internet+" Medical Services
作者:
童禧辰1; 张璐莹1; 李凯渊1; 张森伟1; 苟菲菲1; 陈 文1
1.复旦大学公共卫生学院，上海 200032
Author(s):
TONG Xichen;  ZHANG Luying;  LI Kaiyuan;  ZHANG Senwei;  GOU Feifei;  CHEN Wen
School of Public Health, Fudan University, Shanghai 200032, China
关键词:
“互联网+”医疗服务; 医保支付; 国际经验
Keywords:
"Internet+" medical service;  medical insurance payment;  international experience
分类号:
R19
文献标志码:
A
摘要:
目的：比较分析国内外“互联网+”医疗服务支付现状，为完善我国“互联网+”医疗服务医保支付政策提供参考。方法：通过文献研究法，对比分析美国、澳大利亚、法国、德国及我国“互联网+”医疗服务医保支付政策。结果：各国“互联网+”医疗服务均由公共医疗保险与商业医疗保险共同保障；多数国家采用与线下服务一致的支付标准，并采用按项目付费的支付方式，普遍设有支付限制。我国“互联网+”医疗服务主要由基本医疗保险保障，支付内容以互联网复诊为主，医保准入标准尚不明确，医保支付缺乏有效的风险管控。结论：借鉴国际经验，我国应制定“互联网+”医疗服务动态准入规则，完善医保支付政策，鼓励商业医疗保险参与，健全多层次保障体系，促进“互联网+”医疗服务高质量发展。
Abstract:
Objective To systematically review and compare the current status of "Internet+" medical service payment systems domestically and internationally. Methods Using a literature review approach, the medical insurance payment policies for "Internet plus" medical services in the United States, Australia, France, Germany and China were compared and analyzed. Results In the selected countries, "Internet+" medical services were jointly covered by public and commercial health insurance. Most countries adopted payment standards consistent with those for face-to-face services and used a fee-for-service model, with widespread payment restrictions. In contrast, "Internet+" medical services in China were primarily covered by basic medical insurance, with a focus on online follow-up consultations. Conclusion Drawing on international experience, China should establish dynamic access rules and adjustment mechanisms for "Internet+" medical services, refine related medical insurance payment policies, and encourage active participation from commercial health insurance, so as to facilitate the gradual construction of a medical insurance payment system that supports the high-quality development of "Internet+" medical services.

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更新日期/Last Update: 2025-08-28