摘要
将社区卫生服务门诊纳入城镇居民基本医疗保险是完善城镇医疗保障体系,扩大医疗保险制度受益面的重要措施。上海市长宁区、江苏省无锡市、浙江省宁波市江北区在推进门诊统筹政策的过程中加大对医保的投入、提高对居民的保障程度和水平、向社区卫生服务中心的政策倾斜。在强化社区卫生服务公益性的同时引导居民合理就医,形成了符合不同经济发展水平和医疗条件基础下的门诊统筹"三阶段"模式。未来的政策推广将面临社区卫生服务能力、人员绩效考核以及稳定的医保政策等方面的挑战,卫生部门和医保部门应加强合作,将完善城镇居民基本医疗保险政策与有效的社区卫生服务体系相衔接。
Included the outpatient service provided by community health services centers in Basic Medical Insurance for Urban Residents is an important measure to improve and expand the benefit of the urban basic health insurance system. Changning district of Shanghai, Wuxi, Jiangbei district of Ningbo city increased the investment in health care, raised the level of protection to residents, and prioritized the policy preferences to the community health centers, to strengthening the public welfare of community health services and lead to a rational medical treatment at the same time in the process of policy promote in terms of pooling outpatient services. This leads to establish a ＂three stage＂ model of pooling out in line with different levels of economic development and basis of medical conditions. The future policy promotion would face the challenges of the community medical insurance, staff performance evaluation and the stability of health care policy. The health departments and health care departments should strengthen cooperation to improve policy convergence between the Basic Medical Insurance for Urban Residents and an effective community health service system.
出处
《中国卫生政策研究》
2011年第4期9-15,共7页
Chinese Journal of Health Policy
基金
2009年度国家社会科学基金重大项目(09&ZD059)
复旦大学国家哲学社会科学公共管理与公共政策创新基地2008年项目(08FCZD013)
2010年中国社区卫生科研基金
关键词
社区卫生服务
城镇居民基本医疗保险
门诊统筹
比较分析
Community Health Services
Basic Medical Insurance for Urban Residents
Pooling outpatient
Comparative analysis
