[1]雷 桃,杨金侠,洪梦园,等.医保支付促进慢性病防控策略分析 ——基于利益相关者理论[J].卫生经济研究,2022,39(8):38-41.
 LEI Tao,YANG Jingxia,HONG Mengyuan,et al.Analysis of Medical Insurance Payment to Promote the Prevention and Control of Chronic Diseases ——Based on Stakeholder Theory[J].Journal Press of Health Economics Research,2022,39(8):38-41.
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医保支付促进慢性病防控策略分析
——基于利益相关者理论
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
39
期数:
2022年8期
页码:
38-41
栏目:
公共卫生
出版日期:
2022-07-27

文章信息/Info

Title:
Analysis of Medical Insurance Payment to Promote the Prevention and Control of Chronic Diseases
——Based on Stakeholder Theory
作者:
雷 桃1杨金侠1洪梦园1傅丹敏1
1.安徽医科大学卫生管理学院,安徽 合肥 230032
Author(s):
LEI Tao YANG Jingxia HONG Mengyuan FU Danmin
School of Health Management, Anhui Medical University, Hefei Anhui 230032, China
关键词:
利益相关者医保支付慢性病防控
Keywords:
stakeholders medical insurance payment chronic disease prevention and control
分类号:
R19
文献标志码:
A
摘要:
利用利益相关者理论,对医保支付促进慢性病防控的利益相关者进行定义,并分析了医保部门、卫生行政部门、慢性病防控服务提供者及参保人等利益相关者的利益关系。基于分析结果,提出了医保支付促进慢性病防控的策略:建立与慢性病防控目标相协同的医保支撑体系,实施以价值为导向的医保支付方式改革,通过医保支付政策支持家庭医生签约服务、激励慢性病患者自我管理。
Abstract:
Using the stakeholder theory, this paper defined the stakeholders that medical insurance payment promotes the prevention and control of chronic diseases, and analyzed the interests of stakeholders such as medical insurance departments, health administrative departments, chronic disease prevention and control service providers, and beneficiaries. These results suggested to coordinate medical insurance system with chronic disease prevention and control. To be specific, it is recommended to implement a value-oriented reform of medical insurance payment methods, and support family doctors contracting service as well as incentives self-management of patients through medical insurance payment policies.

参考文献/References:

[1] 冀中慧.慢性病医疗保障存在的问题及对策[J].经济师,2018(11):245-247.
[2] 黄鑫.县域医共体医保支付制度改革研究[D].南昌:南昌大学,2020.
[3] 李运华,雷腾.基本医疗保险部门在慢性病管理中的作用探讨[J].决策与信息,2021(2):31-38.
[4] Freeman R E.The politics of stakeholder theory:Some future directions[J].Business Ethics Quarterly,1994,4(4):409-421.
[5] 张毓辉,万泉,柴培培,等.我国基本医疗保险基金筹集与配置使用情况分析[J].中国医疗保险,2021(3):18-23.
[6] 马强,韩亚蓉.农村基层医务人员离职倾向因素研究[J].南通大学学报(社会科学版),2021,37(2):79-88.
[7] 宋大平,赵东辉,任静,等.医保支持家庭医生签约服务的模式探析[J].中国卫生经济,2018,37(12):67-70.
[8] 赵东辉,付晓光.健康治理视角下的“三医”联动:内涵、目标与实现路径分析[J].中国卫生政策研究,2021,14(1):10-16.
[9] 华颖.健康中国建设:战略意义、当前形势与推进关键[J].国家行政学院学报,2017(6):105-111,163.
[10] 李江,陶沙,李明,等.健康管理的现状与发展策略[J].中国工程科学,2017,19(2):8-15.
[11] 王冬.基于价值医疗的医疗保险支付体系改革创新[J].社会保障评论,2019,3(3):92-103.
[12] 申曙光,张家玉.医保转型与发展:从病有所医走向病有良医[J].社会保障评论,2018,2(3):51-65.
[13] 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.
[14] 朱晓丽,郑英,王清波,等.我国部分地区医联体医保总额预付制改革的比较分析[J].中国医院管理,2020,40(2):21-25.
[15] 杨金侠,江洁.从防控主体出发的社区慢性病防控策略探讨[J].中国卫生事业管理,2011,28(10):729-731.
[16] Miller B F,Ross KM,Davis M M,et al. Payment reform in the patient-cente red medical home:enabling and sustaining integrated behavioral health care[J].Am Psychol,2017,72(1):55-68.
[17] Greb S,Focke A,Hessel F,et al.Financial incentives for disease management programmes and integrated care in German social health insurance[J].Health Policy,2006,78(2-3):295-305.
[18] Foo C,Surendran S,Tam C H,et al.Perceived facilitators and barriers to chronic disease management in primary care networks of Singapore:a qualitative study[J].BMJ Open,2021,11(5):e046010.
[19] 王群,杨瑾,朱坤.德国医疗费用控制的经验与启示[J].卫生经济研究,2019,36(9):22-24,28
[20] 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.

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更新日期/Last Update: 2022-07-27