医疗保险结算模式的比较与思考  

Comparative analysis of medical insurance settlement models

作　　者：陈琳[1] 杨宝林[1] 王与荣[1] 刘玉秀[1] 陈海云[1] 戚苗苗[1] 

机构地区：[1]南京军区南京总医院医务部,江苏南京210002

出　　处：《医学研究生学报》2009年第1期71-74,共4页Journal of Medical Postgraduates

基　　金：南京军区"十五"医药科研基金课题(批准号:05MA003)

摘　　要：从分析医疗服务提供者、被保险人医疗需求以及医疗费用控制的不同影响入手,比较医疗保险供方结算的不同模式、现状和发展趋势,并提出在合理定额、保障大病、满足基本医疗前提下兼顾医疗多层次需求的结算模式建议。We studied the present situation and development trend of the supplier settlement models of medical insurance, and analyzed the effects of different models on the suppliers of medical insurance to the insured and the control of medical expenditure. Then, we put forward a new settlement model that features rational quotas, guarantee serious diseases and satisfaction of multi-level requirements.

关 键 词：医疗保险 医疗费用 结算模式 

分 类 号：R197.32[医药卫生—卫生事业管理]