[1]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):38-40.
 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(2):38-40.
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医保支付促进慢性病管理的国际经验及启示
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
38
期数:
2021年2期
页码:
38-40
栏目:
医保天地
出版日期:
2021-01-20

文章信息/Info

Title:
International Experience and Inspiration of Medical Insurance Payment on Promoting Chronic Disease Management
作者:
陈志鹏1杨金侠1
1.安徽医科大学卫生管理学院,安徽 合肥 230032
Author(s):
CHEN Zhi-pengYANG Jin-xia
School of Health Management,Anhui Medical University,Hefei Anhui 230032,China
关键词:
慢性病管理医保支付国际经验
Keywords:
chronic diseases managementmedical insurance paymentinternational experience
分类号:
R19
文献标志码:
A
摘要:
国外在医保支付促进慢性病管理方面积累了一定经验,包括根据医疗服务价值进行支付、建立风险平衡机制、提供法律保障、依托全科医学体系开展慢性病管理等。我国的慢性病医疗保障存在病种覆盖有限、保障水平较低、支付方式不完善等问题。为此,应在医保制度中引入健康管理机制,提高统筹层次,探索合理的结算方式,不断提高慢性病管理水平。
Abstract:
Foreign countries have accumulated some experience in medical insurance payment to promote chronic disease management,it includes paying according to the value of medical services,establishing a risk equilibrium mechanism,providing legal protection,relying on the general practice system to carry out chronic disease management,and so on.There are some problems in the medical security of chronic diseases in China,such as limited coverage of diseases,low level of security,imperfect mode of payment and so on.For this reason,we should introduce the health management mechanism into the medical insurance system,improve the pooling level,explore reasonable settlement methods,and constantly improve the management level of chronic diseases.

参考文献/References:

[1] 解读《中国防治慢性病中长期规划(2017-2025年)》[EB/OL].(2017-02-14)[2020-06-20].http://www.nhc.gov.cn/jkj/s3586/201702/34a1fff908274ef8b776b5a3fa4d364b.shtml.
[2] 李再强,林枫.医疗保险制度下的慢性病健康管理模式[J].中国卫生经济,2005(1):45-46.
[3] 伊力达尔·阿布都外力.慢性病医保制度对慢性病患者医从性影响分析[J].世界最新医学信息文摘,2018,18(23):11-12.
[4] 孙辉,王海银,谢春艳,等.美国以价值为导向的医保支付模式应用及启示[J].卫生经济研究,2020,37(6):24-27.
[5] 常飞飞,陈先辉,王强.美国“以患者为中心的医疗之家”模式发展现状及对我国家庭医生服务的启示[J].中国全科医学,2017,20(28):3463-3467.
[6] 荆涛,杨舒,许晴.将健康管理纳入基本医保的可行性及策略研究——基于纳入北京市医保的模式设计和策略分析[J].中国卫生事业管理,2018,35(6):421-423,432.
[7] Busse R. Disease management programs in Germany’s statutory health insurance system[J]. Health Aff (Millwood),2004,23:56-67.
[8] Schrijvers G. Disease management: A proposal for a new definition[J]. Int J Integr Care,2009,9:e06.
[9] 周建再,代宝珍.德国慢性病管理现状[J].中国社会保障,2016(12):75-77.
[10] Jacob, L.,et al.Impact of disease management programs on women with breast cancer in Germany. Breast Cancer Research and Treatment, 2015,153(2): 391-395.
[11] 徐望红,张勇,王继伟,等.中日两国慢性病防控策略比较及政策启示[J].中国慢性病预防与控制,2016,24(8):593-596.
[12] 刘晓莉.日本预防控制慢性病新型健康管理模式的研究及启示[D].重庆医科大学,2010.
[13] 朱敏,吴华章.澳大利亚国民慢性病战略及其启示[J].中国慢性病预防与控制,2010,18(5):539-541.
[14] 应亮,杨辉.澳大利亚慢性病管理计划及其对中国的启示[J].中国全科医学,2019,22(34):4184-4189.

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更新日期/Last Update: 2021-01-27