本文關(guān)鍵詞： 醫(yī)療保險 制度整合 醫(yī)療衛(wèi)生資源 分級診療　出處：《西北農(nóng)林科技大學(xué)學(xué)報(社會科學(xué)版)》2016年05期 　論文類型：期刊論文

【摘要】：整合城鄉(xiāng)居民基本醫(yī)療保險制度是建立更加公平可持續(xù)的全民醫(yī)保制度的必然要求和基礎(chǔ)條件,是我國醫(yī)保制度發(fā)展與完善的必經(jīng)之路。雖然部分地區(qū)在整合中取得了一定的成就,但是仍存在諸多問題:政策的不明確導(dǎo)致管理體制混亂,醫(yī)療衛(wèi)生資源配置不均衡導(dǎo)致整合后的不公平,待遇的"就高不就低"取向會對醫(yī)�；甬a(chǎn)生一定的壓力,繳費方式的選取不慎會影響制度的可持續(xù)和社會的穩(wěn)定,"兩定"的整合和分級診療的不完善導(dǎo)致大醫(yī)院的壓力增加等問題。因此,需要理順城鄉(xiāng)居民基本醫(yī)療保險制度整合的管理體制,注重城鄉(xiāng)居民醫(yī)�；鸬拈_源節(jié)流和保值增值,推進(jìn)醫(yī)療衛(wèi)生資源的合理配置,增強對同質(zhì)醫(yī)療衛(wèi)生資源的可及性,選擇適合各地地情的繳費方式,實現(xiàn)制度的平穩(wěn)過渡,加快分級診療的實施進(jìn)度,減輕大醫(yī)院的就醫(yī)壓力。
[Abstract]:Integrating the basic medical insurance system of urban and rural residents is the inevitable requirement and basic condition of establishing a more equitable and sustainable universal medical insurance system. Although some areas have made some achievements in the integration, there are still many problems: the unclear policy leads to the confusion of the management system. The unbalanced allocation of medical and health resources leads to the unfairness after integration, and the orientation of "high or low" will have a certain pressure on the health insurance fund. The selection of payment methods will affect the sustainability of the system and social stability. The integration of "two determinations" and the imperfect grading of diagnosis and treatment will lead to the increase of pressure in large hospitals and so on. It is necessary to straighten out the management system of the basic medical insurance system of urban and rural residents, pay attention to the increase of income and increase the value of health insurance fund, and promote the rational allocation of medical and health resources. To enhance the accessibility of homogeneous medical and health resources, to choose the appropriate payment method for local conditions, to realize the smooth transition of the system, to speed up the implementation of graded diagnosis and treatment, and to reduce the pressure of medical treatment in large hospitals.
【作者單位】： 中國醫(yī)療保險研究會;中國海洋大學(xué)法政學(xué)院;
【基金】：國家自然科學(xué)基金重點項目(713300065)
【分類號】：F842.684
【正文快照】： 黨的十八大和十八屆三中全會都明確提出整合城鄉(xiāng)居民基本醫(yī)療保險制度,該制度的整合是建立更加公平可持續(xù)的全民醫(yī)保制度的必然要求和基礎(chǔ)條件,是我國醫(yī)保制度發(fā)展與完善的必經(jīng)之路。截止到2015年3月底,在區(qū)域內(nèi)全部實現(xiàn)整合的有重慶、天津、青海、廣東、寧夏、山東、浙江、新

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