本文選題：社區(qū)衛(wèi)生 + 社會醫(yī)療保險��； 參考：《山西財經(jīng)大學》2013年碩士論文

【摘要】：社區(qū)衛(wèi)生服務(wù)是能提供預(yù)防、健康教育、婦幼保健、慢性病康復(fù)等功能的基層醫(yī)療衛(wèi)生服務(wù)；社區(qū)衛(wèi)生服務(wù)是公益性的基層衛(wèi)生服務(wù)。其發(fā)展的根本目的就是讓參保職工、還包括參加其他類型保險的居民能公平的享受醫(yī)療衛(wèi)生服務(wù)。其廣覆蓋、低成本、便利性的特點讓社區(qū)居民足不出戶就能解決小病、常見病，，進行慢性病康復(fù)。 社區(qū)衛(wèi)生服務(wù)與醫(yī)療保險相輔相成，共同發(fā)展。社會醫(yī)療保險一方面為社區(qū)衛(wèi)生提供政策引導(dǎo)，比如，限定了紡配社區(qū)衛(wèi)生服務(wù)站必須管轄1萬人及以上；另一方面，社會醫(yī)療保險還給社區(qū)衛(wèi)生提供了資金保障。社區(qū)衛(wèi)生服務(wù)既保護了人才資源，又促進了社會的和諧穩(wěn)定。在社區(qū)衛(wèi)生服務(wù)就診所花費的醫(yī)療費用低于大醫(yī)院，如果在社區(qū)解決小病、常見病就能減少參保居民的醫(yī)療費用支出，也能降低社會醫(yī)療保險統(tǒng)籌基金的支付壓力。社區(qū)衛(wèi)生服務(wù)承接社會醫(yī)療保險的路徑就是通過醫(yī)療保險定點審核后，向社區(qū)參保居民提供醫(yī)療服務(wù)。社區(qū)衛(wèi)生服務(wù)與醫(yī)療保險的承接方式就是通過醫(yī)�；颊撸⑶乙揽酷t(yī)保病種和衛(wèi)生服務(wù)站站內(nèi)醫(yī)保收入來體現(xiàn)。 榆次紡配社區(qū)衛(wèi)生服務(wù)站在經(jīng)過榆次區(qū)醫(yī)保中心醫(yī)保定點審核通過后，向紡配社區(qū)的居民提供基本醫(yī)療衛(wèi)生服務(wù)，包括為居民建立健康檔案、進行健康教育講座、關(guān)注高危人群，即經(jīng)常吸煙且缺乏鍛煉的人群、婦幼保健、定期專家咨詢、慢性病管理。雖然在降低醫(yī)療服務(wù)成本、提高服務(wù)水平、方便群眾方面取得一定的成果，但是仍然在制度配套和衛(wèi)生服務(wù)站自身建設(shè)方面存在一定的問題，必須通過完善法律制度、加大制度建設(shè)和政府財政扶持力度、加強社區(qū)衛(wèi)生自身建設(shè)四個方面來促進榆次紡配社區(qū)衛(wèi)生服務(wù)承接醫(yī)療保險的發(fā)展。
[Abstract]:Community health service is a primary health service which can provide prevention, health education, maternal and child health care, rehabilitation of chronic diseases and so on, and community health service is a basic health service of public welfare.The fundamental goal of the development is to provide equal access to health services for insured workers and other types of insurance.Its wide coverage, low-cost, convenient characteristics enable community residents to solve minor diseases, common diseases, chronic disease rehabilitation.Community health service and medical insurance complement each other and develop together.On the one hand, social medical insurance provides policy guidance for community health, for example, it limits that the spinning community health service station must have jurisdiction over 10,000 people and more; on the other hand, social medical insurance also provides financial security for community health.Community health service not only protects human resources, but also promotes social harmony and stability.The cost of medical treatment in community health service is lower than that in large hospital. If we solve the minor disease in the community, the common disease can reduce the medical expenses of the insured residents, and can also reduce the payment pressure of the social medical insurance plan fund.The path of community health service to undertake social medical insurance is to provide medical service to the residents of community insurance after the fixed-point audit of medical insurance.The way of undertaking community health service and medical insurance is through medical insurance patient, and it depends on medical insurance disease and medical insurance income in health service station.The Yuci spinning Community Health Service Station has provided basic medical and health services to the residents of the spinning and distribution community after it has been approved by the Yuci District Medical Insurance Center for medical insurance, including setting up health files for the residents and conducting health education talks.Focus on high-risk groups, that is, frequent smokers and lack of exercise, maternal and child health care, regular expert consultation, chronic disease management.Although certain achievements have been made in reducing the cost of medical services, improving the service level, and making it convenient for the masses, there are still some problems in supporting the system and in the construction of the health service station itself. We must improve the legal system.Strengthen the system construction and the government financial support, strengthen the community health self-construction four aspects to promote the Yuci textile community health service to undertake the development of medical insurance.
【學位授予單位】：山西財經(jīng)大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R197.1;F842.684

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