中国卫生事业管理2026，Vol.43Issue(8)：886-891,6.
英国NHS反欺诈治理的实践经验与启示
Practice and Enlightenment from Anti-Fraud Governance in the UK NHS
摘要
Abstract
The security of public medical funds is an important foundation for the sustainable operation of the medical security sys-tem.Since the late 1990s,the British NHS has gradually established an anti-fraud governance system supported by specialized institu-tions,legal rules,digital technology and integrity culture.On the basis of distinguishing the institutional differences between the British NHS and China's medical insurance fund,the NHS anti-fraud governance experience were reviewed from four dimensions of organiza-tional system,legal system,technology application and cultural construction.The study found that the effectiveness of NHS anti-fraud governance depended on the coordination of specialized organization,standardized rules,digital supervision and integrity culture.China should strengthen the specialization and coordination of medical insurance anti-fraud supervision within the existing regulatory frame-work,improve classified regulation and liability linkage,promote data-driven intelligent supervision,strengthen integrity compliance governance,and transform anti-fraud governance from phased rectification to long-term governance.关键词
医保基金/反欺诈治理/英国NHS/智能监管/诚信合规Key words
medical insurance fund/anti-fraud governance/British NHS/intelligent supervision/integrity compliance分类
医药卫生引用本文复制引用
林源..英国NHS反欺诈治理的实践经验与启示[J].中国卫生事业管理,2026,43(8):886-891,6.基金项目
国家社会科学基金项目"基于大数据的社会医疗保险欺诈行为识别、损失测度与协同治理研究"(22BJY118) （22BJY118）
