摘要
随着全民医疗保险制度的不断完善,医保参保病人的看病负担得到了有效缓解。"看病贵"问题更多地表现为不能为各种医疗保险所覆盖的医疗服务、技术与药品等相关直接自付费用。本研究调查了上海城镇职工参保病人在各级医院住院的自付费用负担情况。研究发现,部分科室的医保住院病人存在自费比例偏高的情况,自费费用比较集中的领域是手术耗材、进口药物和专项检查等,但各级医疗机构对于参保病人自费比例的认识不足。为此,在政策上应着力于构筑医院控制自费比例的内在动力机制;建立和完善医疗自费全过程监管机制,加强对重点医院、重点科室、重点领域的监管;适当扩大和完善保障范围,鼓励引导商业医疗保险发展。
With the continuous improvement of the universal medical insurance system, the medical insurance patients burden of illness has been effectively alleviated.The problem of ＂seeing a doctor expensively＂ is due to the direct payment for medical service, technology and drugs which can not covered by various medical insurance .The study investigated the self payment burden of insured patients in hospital of dissimilarity Class in Shanghai.The study found that some departments of hospitalized patients have a higher proportion of their own expense, the cost of their own relatively concentrated areas are operating consumables, imported drugs and special inspection.However, medical institutions at all levels have insufficient awareness of the proportion of insured patients at their own expense.Therefore, the internal motive mechanism of controlling the proportion of self expense should be focused on the policy;At the same time, establish and improve the whole process of medical supervision mechanism, strengthen supervision of key hospitals, key departments and key areas.We should appropriately expand and improve the scope of protection, and encourage and guide.the development of commercial medical insurance.
出处
《中国医疗保险》
2017年第6期32-35,共4页
China Health Insurance
基金
2014年度国家自然科学基金面上项目(项目批准号:71373042)
关键词
城镇职工医疗保险
住院负担
政策思考
urban workers medical insurance, hospitalization burden, policy thinking
