职工医疗制度改革试点一年的回顾  

A year's reform experiment of workers' medical program

作　　者：郑国强[1] 

机构地区：[1]江苏省镇江市第一人民医院,212002

出　　处：《中华医院管理杂志》1996年第10期598-600,共3页Chinese Journal of Hospital Administration

摘　　要：镇江市职工医疗制度改革试点已一年,从试点城市规模最大的医院运作结果来看,医疗制度改革取得了如下成果:①探索出了一个以社会统筹医疗基金与个人帐户相结合的职工医疗保障新体制和新机制,切实保障了广大职工的基本医疗;②有效遏制了医疗费用增长过快的势头;③不规范医疗行为得到纠正,医德医风进一步好转;④为制定区域卫生规划打下了良好基础;⑤积极推进了医院内部的各项改革,制定了与职工医疗保险制度相适应的运行机制。在分析了改革中存在的主要问题后提出以下建议;①建立健全适应新的职工医疗制度要求的医院补偿机制;②定额的制定必须进一步完善,使之科学化、合理化;③医和药必须同步改革;④职工基本医疗的范围应与当地的财政和社会经济承受能力相适应;⑤应积极制定和推行区域性卫生规划。A year′s reform experiment on workers′medical program in Zhenjiang′s biggest hospital shows that many positive results have been obtained as follows:①a new workers;medical security pro- grain and with it a new mechanism have been found,combining the general social fund with individul medical account to insure the practcal right of health protection of the working masses②the rocketing of medical cost is effectively stopped;③abnormal hospital behaviors are considerable corrected and the medical moral is further improved;④a good foundation is laid for the establishment of regional health planning; and⑤ the hospital′s intra -- reforms are positively pushed forward and an operational mecha- nism formed to fit in with workers′medical program.On analyzing the main problems that cropped up in the reform,suggestions to solve them are made as follows:①a complete and innovative hospital com- pensation mechanism be set up to meet the demand of the workers′medical program;②the setting--up of quotas be further improved to make the quotas more scientific and rational;③the reform of medicine be synchronized with that of drug;④the basic medical coverage of the workers be accorded with local financial and social--economic capacity;and⑤regional health planning be actively prepared and carried out.

关 键 词：医疗保障制度 医院改革 医疗服务制度 

分 类 号：R197.1[医药卫生—卫生事业管理]