中国农村卫生事业管理2024，Vol.44Issue(11)：793-798,6.DOI:10.19955/j.cnki.1005-5916.2024.11.006
贵州省城乡居民基本医疗保险门诊统筹政策研究
Outpatient fund pooling policies of basic medical insurance for urban and rural residents in Guizhou Province
摘要
Abstract
Based on literature review and interviews in some primary healthcare institutions,this paper re-viewed the policy characteristics of outpatient fund pooling of basic medical insurance for urban and rural residents in Guizhou Province from the financing mode,coverage,service management system,treatment policies(mini-mum payment line,compensation ratio,top line),settlement mode,etc.,and then compared these policies with those implemented in some typical domestic cities.On this basis,the paper drew the following conclusions:the expected goal of strengthening grassroots medical institutions through outpatient fund pooling policy has not yet been achieved;the management mode is a bit extensive,and it is necessary to improve the level of refined man-agement;it is vital to optimize system design and ensure the guarantee capability;a dynamic adjustment mecha-nism should be established,and regions with good economic conditions may try separate fundraising.关键词
居民/基本医疗保险/门诊统筹/政策特点/评价/管理机制Key words
Resident/Basic health insurance/Outpatient fund pooling/Policy characteristics/Evalua-tion/Management mechanism分类
医药卫生引用本文复制引用
冯毅..贵州省城乡居民基本医疗保险门诊统筹政策研究[J].中国农村卫生事业管理,2024,44(11):793-798,6.基金项目
贵州省哲学社会科学规划课题(22GZYB69) （22GZYB69）
