摘要
总额预付制是根据医保筹资结合医院实际运行情况,由医保部门对医院评估后,根据服务量和人均医疗费用,测算出医院的年度费用标准,并按该标准向医院预付医药费总额。对实行总额预付以后的优缺点进行了分析,指出存在的问题。对总额预付的运用及改进提出了设想,以期推动付费方式改革的良性发展。
Based on the medical insurance financing combined with the actual operation of the hospital,by the Medical Insurance Department to the hospital evaluation,and according to the amount of service and per capita medical expenses,the total prepayment system is used to calculate the hospital’s annual cost standard,and according to the standard prepaid medical expenses to the hospital. The paper analyzes the advantages and disadvantages of the total amount of prepayment,and points out the existing problems. The paper puts forward some ideas on the application and improvement of total prepayment,in order to promote the benign development of payment mode reform.
作者
吴丽琴
徐志良
WU Li-qin;XU Zhi-liang(Wujin Hospital of TCM,Changzhou,Jiangsu,213161,China)
出处
《中国医院管理》
北大核心
2019年第12期63-64,共2页
Chinese Hospital Management
关键词
医疗保险
总额预付制
改革
medical insurance
total advance payment
reform
