中国农村卫生事业管理2025，Vol.45Issue(1)：12-18,7.DOI:10.19955/j.cnki.1005-5916.2025.01.003
政策工具视角下我国医联体医保支付方式改革政策研究
Policy research on the reform of medical insurance payment methods of medical alliances in China from the perspective of policy tools
摘要
Abstract
Objective To explore the focus and shorcomings of the policy system by analyzing the current policies related to the reform of the medical insurance payment methods of medical alliances in China,so as to pro-vide reference for optimization of the policies and the development of medical alliances.Methods Based on the theory of policy tools,we constructed a three-dimensional analytical framework of"policy tools(dimension X)—stakeholders(dimension Y)—policy goals(dimension Z)"to analyze the policies related to medical insurance payment reform in medical alliances at national,provincial and municipal levels from 2017 to 2023.Results In the X dimension,environmental,demand-type,and supply-type policy tools accounted for 46.1％,35.8％,and 18.2％,respectively;in the Y dimension,the four parties of stakeholders,namely,the lead hospitals and mem-bers of the medical alliances,medical insurance institutions,medical staff,and patients,accounted for 46.4％,25.4％,18.6％,and 9.5％,respectively;in the Z dimension,regulating the control of the medical insurance funds,optimizing the allocation of medical resources,and improving the level of service guarantee accounted for 39.6％,35.4％,and 25.1％,respectively.Conclusions It is vital to optimize top-level design with policy ob-jectives as a guide,foster synergy among policy tools,refine tool combinations,balance stakeholder needs,and assess tool-stakeholder-objective alignment to promote the healthy practices of medical insurance payment within medical alliances.关键词
医联体/医保支付方式/政策工具/利益相关者/政策目标/内容分析/政策文本Key words
Medical alliance/Medical insurance payment method/Policy tool/Stakeholder/Policy goal/Content Analysis/Policy Text分类
预防医学引用本文复制引用
余星颖,吴彦龙,朱平华..政策工具视角下我国医联体医保支付方式改革政策研究[J].中国农村卫生事业管理,2025,45(1):12-18,7.基金项目
广西高校人文社科重点研究基地健康与经济社会发展研究中心立项课题(2024RWB02) （2024RWB02）
广西高等学校千名中青年骨干教师培育计划人文社会科学类立项课题(2023QGRW015) （2023QGRW015）
