[1]杨燕绥,常焙筌,秦 晨,等.医保复合型付费的“约束-引导-激励”机制研究——契约科学和社会治理下金华医保改革实践[J].卫生经济研究,2021,38(12):7-10.
　YANG Yan-sui,CHANG Bei-quan,QIN Chen,et al.Research on the "Constraint-Guidance-Incentive" Mechanism of Compound Payment of Medical Insurance——The Practice of Medical Insurance Reform in Jinhua City Under Contract Science and Social Governance Theory[J].Journal Press of Health Economics Research,2021,38(12):7-10.
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医保复合型付费的“约束-引导-激励”机制研究
——契约科学和社会治理下金华医保改革实践
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
38
期数:
2021年12期
页码:
7-10
栏目:
专家视野
出版日期:
2021-12-02

文章信息/Info

Title:
Research on the "Constraint-Guidance-Incentive" Mechanism of Compound Payment of Medical Insurance
——The Practice of Medical Insurance Reform in Jinhua City Under Contract Science and Social Governance Theory
作者:
杨燕绥1; 常焙筌2; 秦 晨; 周燕祥3; 邵宁军3; 江小州3
1.清华大学医院管理研究院，广东 深圳518055
2.清华大学公共管理学院，北京 100084
3.浙江省金华市医疗保障局，浙江 金华321000
Author(s):
YANG Yan-sui;  CHANG Bei-quan;  QIN Chen;  ZHOU Yan-xiang;  SHAO Ning-jun;  JIANG Xiao-zhou
Hospital Management Research Institute, Tsinghua University，Shenzhen Guangdong 518055, China
关键词:
契约科学; 社会治理; 医保复合型付费; 支付制度改革
Keywords:
contract science;  social governance;  compound payment of medical insurance;  payment method reform
分类号:
F840.684
文献标志码:
A
摘要:
契约科学和社会治理的理论在我国医疗保障领域逐渐得到发展应用。目前我国医保政策强调“复合型付费”，本文基于均值定价、激励相融、剩余控制权三个理论，构建契约科学理论框架，解释医保复合型付费 “约束-引导-激励”机制的作用机理、逻辑关系和预期结果，并以金华市医保支付制度改革为例进行验证。在此基础上，提出完善医保“约束-引导-激励”机制的建议。
Abstract:
The theory of contract science and social governance has been gradually developed and applied in the field of medical insurance in China. At present, the Chinese medical insurance policy emphasizes "compound payment". Based on the three theories of mean pricing, incentive orientation and residual rights of control, this paper constructs the theoretical framework of contract science to explain the mechanism, logical relationship and expected results of the "constraint-guidance-incentive" mechanism of the compound medical insurance payment, and take the medical insurance payment system reform in Jinhua as an example to confirm. On this basis, this paper puts forward some suggestions on how to improve the "constraint-guidance-incentive" mechanism of medical insurance.

参考文献/References:

[1] Kenneth J.Arrow.Uncertainty and the Welfare Economics of Medical Care[J].The American Economic Review，1963，53（5）：941-973.
[2] Hurwicz L.On informationally decentralized systems.In Decision and Organization:A Volume in Honor of Jacob Marschak,ed.R. Radner and C.B.McGuire,Amsterdam:North-Holland，1972：297-336.
[3] Hart Oliver.Incomplete Contracts and Control[J].American Economic Review，2017，107(7):1731-1752.
[4] 愈炳匡.医疗改革的经济学[M].北京:中信出版社，2008：158-170.
[5] Christopher Moriates,Vineet A,Christopher M,et al.以价值为导向的医疗服务[M].北京:北京大学医学出版社,2018:78.

更新日期/Last Update: 2021-12-02