[1]李乐乐.我国医疗保障制度高质量发展：“十四五”成就与“十五五”展望[J].卫生经济研究,2026,43(02):8-13.
　LI Lele.High-Quality Development of China's Medical Security System: Achievement During the 14th Five-Year Plan Period and Prospects for the 15th Five-Year Plan Period[J].Journal Press of Health Economics Research,2026,43(02):8-13.
点击复制

我国医疗保障制度高质量发展：“十四五”成就与“十五五”展望

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
43
期数:
2026年02期
页码:
8-13
栏目:
卫生健康发展“十五五”专栏
出版日期:
2026-01-31

文章信息/Info

Title:
High-Quality Development of China's Medical Security System: Achievement During the 14th Five-Year Plan Period and Prospects for the 15th Five-Year Plan Period
作者:
李乐乐1
1.中国人民大学劳动人事学院，北京 100872
Author(s):
LI Lele
School of Labor and Human Resources, Renmin University of China, Beijing 100872, China
关键词:
医疗保障制度; 高质量发展; “十四五”成就; “十五五”展望
Keywords:
medical security system;  high-quality development;  achievement during the 14th Five-Year Plan Period;  prospects for the 15th Five-Year Plan Period
分类号:
F840.684，R19
文献标志码:
A
摘要:
医疗保障制度是减轻群众就医负担、增进民生福祉、维护社会和谐稳定的重大制度安排。“十四五”时期，我国医疗保障制度在体系完善、保障待遇提升、基金监管强化、服务效能优化、法制体系建设等多个领域取得了突破性进展，但也存在制度整合与公平性不足、筹资责任失衡、保障功能薄弱、法治化与监管滞后、“三医”联动协同不足等深层次问题。“十五五”时期，我国医疗保障制度高质量发展应坚持普惠公平，推动制度整合与社会共享；持续优化资源配置，提升服务质效与系统协同；深化科技赋能与法治保障，提升治理效能，从而构建更加公平、高效、可持续的中国特色医疗保障体系。
Abstract:
The medical security system is a crucial institutional arrangement for reducing residents' medical burdens, improving people's well-being, and maintaining social harmony and stability. During the 14th Five-Year Plan period, China's medical security system has achieved breakthrough progress in multiple areas, including institutional improvement, benefit enhancement, fund supervision, service optimization and legal construction. However, there are also deep-seated issues, such as insufficient institutional integration and fairness, unbalanced financing responsibilities, weak security functions, lagging legalization and supervision, and inadequate coordination among medical services, medical insurance and pharmaceutical industries (the "Three-Medical Linkage"). Furthermore, during the 15th Five-Year Plan period, high-quality development of China's medical security system should adhere to inclusive and equitable development, promote institutional integration and social sharing, continuously optimize resource allocation, improve service quality, efficiency and systematic coordination, deepen empowerment by science and technology as well as legal protection, and improve governance efficiency. It provides a reference for building a more equitable, efficient and sustainable medical security system with Chinese characteristics.

参考文献/References:

[1] 舒国宋，金春林，王力男，等.我国基本医疗保障制度高质量发展面临的关键问题及对策[J].中国卫生经济，2024，43（05）：43-47.
[2] 谢士钰，赵德余，王艳，等.地方政府制度创新如何吸引中央政策注意力?——基于医改简报的文本分析[J].中国卫生政策研究，2023，16（11）：24-30.
[3] 刘珏，梁万年.科技创新应对健康挑战[J].中国全科医学，2024，27（28）：3449-3452.
[4] 龚曦，王红波.整体性治理视域下多层次医疗保障体系的概念厘定、发展困境及路径选择[J].中国卫生政策研究，2024，17（02）：1-8.
[5] 但彦铮.加快《医疗保障法》立法进程全面推进法治医保建设的几点思考[J].中国医疗保险，2022（02）：1-4.
[6] 何文炯.基于共同富裕的医疗保障体系优化[J].中国高校社会科学，2024（05）：56-66，158.
[7] 郑功成.“十四五”时期中国医疗保障制度的发展思路与重点任务[J].中国人民大学学报，2020，34（05）：2-14.
[8] 何文炯，潘旭华.基于共同富裕的社会保障制度深化改革[J].江淮论坛，2021（03）：133-140.
[9] 郑功成.全面深化医保改革：进展、挑战与纵深推进[J].行政管理改革，2021（10）：12-25.
[10] 顾海，吴迪.“十四五”时期基本医疗保障制度高质量发展的基本内涵与战略构想[J].管理世界，2021，37（09）：158-167.
[11] 飞琼.中国多层次医疗保障体系建设现状与政策选择[J].中国人民大学学报，2020，34（05）：15-24.

相似文献/References:

[1]于保荣.未来5～10年中国医疗保障制度的设计与思考——《中共中央 国务院关于深化医疗保障制度改革的意见》的解读[J].卫生经济研究,2020,(04):3.
　YU Bao-rong.Design and Thinking of China's Medical Security System in the Next 5-10 Years——Interpretation of Opinions on Deepening the Reform of the Medical Security System by the Central Committee of the Communist Party of China and the State Council[J].Journal Press of Health Economics Research,2020,(02):3.
[2]程玉敏,黄凤明.医疗保障制度应对突发公共卫生事件的作用机制及思考[J].卫生经济研究,2020,(06):10.
　CHENG Yu-min,HUANG Feng-ming.The Mechanism and Thinking on Medical Security System Responding to Public Health Emergencies[J].Journal Press of Health Economics Research,2020,(02):10.
[3]洪朝阳.新时代大型公立医院高质量发展的实践与思考[J].卫生经济研究,2021,38(7):3.
　HONG Chao-yang.Practice and Reflection on the High-quality Development of Large Public Hospitals in the New Era[J].Journal Press of Health Economics Research,2021,38(02):3.
[4]江蒙喜,甘 戈.公立医院高质量发展的要素研究[J].卫生经济研究,2021,38(7):8.
　JIANG Meng-xi,GAN Ge.Research on the Elements of High-quality Development of Public Hospitals[J].Journal Press of Health Economics Research,2021,38(02):8.
[5]庞 雁.全面内控助力公立医院高质量发展——基于H医院“阳光内控平台”建设的经验[J].卫生经济研究,2021,38(11):68.
　PANG Yan.Comprehensive Internal Control Promote High-quality Development of Public Hospitals——Based on the Construction Experience of the "Sunshine Internal Control Platform" of H Hospital[J].Journal Press of Health Economics Research,2021,38(02):68.
[6]屈 贞.高质量结合：城市社区医养结合的方向[J].卫生经济研究,2022,39(1):27.
　QU Zhen.High-quality Integration: the Integrate Direction of Medical and Nursing Care in Urban Communities[J].Journal Press of Health Economics Research,2022,39(02):27.
[7]陈奕男.长期护理保险高质量发展的依据、框架与路径[J].卫生经济研究,2022,39(4):37.
　CHEN Yi-nan.Evidence, Framework and Path for High-Quality Development of Long-Term Care Insurance[J].Journal Press of Health Economics Research,2022,39(02):37.
[8]杨征帆.公立医院全面预算管理的实践探索[J].卫生经济研究,2022,39(4):90.
　YANG Zheng-fan.Practice of Comprehensive Budget Management in Public Hospitals[J].Journal Press of Health Economics Research,2022,39(02):90.
[9]黄广成,张远妮,姜 虹,等.公立医院经济运行监测评价指标体系构建 ——基于高质量发展视角[J].卫生经济研究,2022,39(5):63.
　HUANG Guang-cheng,ZHANG Yuan-ni,JIANG Hong,et al.Construction of the Monitoring and Evaluation Index System of Public Hospital Economic Operation——From the Perspective of High-Quality Development[J].Journal Press of Health Economics Research,2022,39(02):63.
[10]王荣荣,郭 锋,张毓辉.新时期健康产业的高质量发展：挑战、机遇与路径研究[J].卫生经济研究,2022,39(6):1.
　WANG Rongrong,GUO Feng,ZHANG Yuhui.High-Quality Development of Health Industry in The New Era: Research on Challenges, Opportunities and Paths[J].Journal Press of Health Economics Research,2022,39(02):1.

更新日期/Last Update: 2026-02-03