[1]李 玲,陈永法.日本个人医疗费用封顶制实践及启示[J].卫生经济研究,2024,41(07):63-66.
　LI Ling,CHEN Yongfa.Practice and Inspiration of the Capping System for Individual Medical Expense in Japan[J].Journal Press of Health Economics Research,2024,41(07):63-66.
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日本个人医疗费用封顶制实践及启示
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
41
期数:
2024年07期
页码:
63-66
栏目:
他山之石
出版日期:
2024-07-03

文章信息/Info

Title:
Practice and Inspiration of the Capping System for Individual Medical Expense in Japan
作者:
李 玲1; 陈永法1
1.中国药科大学国际医药商学院，江苏 南京 211198
Author(s):
LI Ling;  CHEN Yongfa
School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing Jiangsu 211198, China
关键词:
医疗保障; 个人医疗费用封顶制; 高额疗养费制度; 日本
Keywords:
medical insurance;  capping system for individual medical expense;  high-cost medical expense system;  Japan
分类号:
F840.684
文献标志码:
A
摘要:
日本个人医疗费用封顶制以患者利益为主导，聚焦重大疾病保障；制度改革循序渐进，确保了医保基金可持续；自付限额以年龄和收入为划分维度，防止了泛福利化。这些实践经验对我国未来实施个人医疗费用封顶制具有一定的借鉴意义。我国应逐步优化基本医疗保障资源配置，设置与家庭收入相挂钩的自付限额，明确个人医疗费用封顶制的保障范围，创新医保支付方式和医疗过程监督机制。
Abstract:
The capping system for individual medical expense in Japan is driven by the interests of patients and focuses on major disease security. The system reform is gradual and ensures the sustainability of the medical insurance fund. The out-of-pocket limit is divided based on age and income to prevent pan-welfarization. These practical experiences have certain significance for the future implementation of the capping system for individual medical expense in China. It is necessary to gradually optimize the allocation of basic medical insurance resources, set out-of-pocket limits linked to family income, clarify the coverage of the capping system for individual medical expense, and innovate the payment method of medical insurance and the monitoring mechanism of the medical process.

参考文献/References:

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更新日期/Last Update: 2024-07-03