[1]张晓香,李紫娟,吕国营.异地就医直接结算与医疗服务利用公平性研究[J].卫生经济研究,2019,(12):36-38.
 ZHANG Xiao-xiang,LI Zi-juan,LYU Guo-ying.Study on the Direct billing of Medical Treatment in Different Places and the Fairness of Medical Service Utilization[J].Journal Press of Health Economics Research,2019,(12):36-38.
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异地就医直接结算与医疗服务利用公平性研究
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
期数:
2019年12期
页码:
36-38
栏目:
医保天地
出版日期:
2019-11-29

文章信息/Info

Title:
Study on the Direct billing of Medical Treatment in Different Places and the Fairness of Medical Service Utilization
作者:
张晓香12李紫娟1吕国营2
1.湖北中医药大学,湖北 武汉430065
2.中南财经政法大学,湖北 武汉430073
Author(s):
ZHANG Xiao-xiangLI Zi-juanLYU Guo-ying
Hubei University of Traditional Chinese Medicine,Wuhan Hubei 430065,China
关键词:
异地就医直接结算医疗服务利用公平性
Keywords:
direct billing of allopatry medical treatmentutilization of medical servicesfairness
分类号:
R19
文献标志码:
A
摘要:
基于A市异地就医直接结算患者数据,探讨医疗服务利用公平性。结果显示,城镇职工基本医疗保险补偿对异地就医患者存在“亲国企不平等”和“离退休补偿水平过高”问题。为保障参保地城镇职工基本医疗保险精算平衡,必须利用大数据规范国企参保人的转诊转院,做实分级诊疗,同时医保支付方式改革与支付标准相配套,并考虑退休人员医保缴费。
Abstract:
Based on the direct billing of allopatry patient data in A city,the medical service utilization fairness was discussed. The results showed that the basic medical insurance compensation for urban workers had the problem of “inequality in national and other enterprises” and “high level of compensation for retiree” for allopatry patients. It is necessary to use the big data to regulate the referral of the state-owned enterprise insured to the hospital for real-level medical treatment. At the same time,the reform of the medical insurance payment method should be matched with the payment standard,and the retirees' medical insurance contributions considered.

参考文献/References:

[1] 单苗苗.基本医疗保险异地就医直接结算的回顾和反思[J].中国人力资源社会保障,2018(12):25-26.
[2] 崔克春,徐凌忠.卫生服务利用的公平性及其影响因素研究综述[J].卫生软科学,2010,24(5):388-391.

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更新日期/Last Update: 2019-11-29