摘要
荷兰试图通过医保捆绑支付改革来推动卫生服务整合。文章总结梳理了捆绑支付的制度设计,发现捆绑支付促进了卫生服务提供者之间的协调与合作,但也带来医疗费用增加、医保重复支付和管理成本增加等问题。剖析了我国支付方式对卫生服务整合导向性作用缺位的现状,提出支付方式改革对推动卫生服务提供体系改革的作用,倡导通过支付方式改革营造竞争环境,指出直接作用于医生的支付方式的重要性,并提出变捆绑支付为基于风险调整的按人头支付的制度优化建议。
The Netherlands tried to improve health care, integration through the bundled payments reform. It summarized the bundied payments policy and designs. The bundled payments promoted the coordination and collaboration between different health care providers. However, it increased medical costs, led to double payments and caused high administrative burden. It also analyzed the role of medical insurance payments for the integration of health care delivery system in China. It put forward the significant role of medial insurance payments in health care integration, called for the competitive environment for payment method reform, pointed the importance of direct insurance payments for doctors and the direction for risk-adjusted integrated capitation payments.
出处
《中国卫生经济》
北大核心
2016年第10期94-96,共3页
Chinese Health Economics
基金
国家自然科学基金青年基金项目(71403092)
博士后基金项目(2014M562035)
关键词
医疗保险
捆绑支付
卫生服务整合
荷兰
medical insurance
bundled payments
health care integration
Netherlands
