关于加强医保定点医疗机构监管的思考  

Considerations on enforcing supervision of the certified hospitals of the medical security system

作　　者：孙海涛[1] 陈羲[2] 阳昊[2] 

机构地区：[1]中山大学光华口腔医学院,广州510055 [2]华中科技大学同济医学院医药卫生管理学院,武汉430030

出　　处：《国际医药卫生导报》2009年第5期124-126,共3页International Medicine and Health Guidance News

摘　　要：建立覆盖城乡居民医疗保障体系，对加强定点医疗机构的监管提出了新的要求和挑战。本文论述了在建立覆盖城乡居民医疗保障体系中加强定点医疗机构监管的必要性，主要体现在：政府职能转变的必然要求，医疗服务主体有效治理的重要手段，保障基金安全的迫切需要。提出了加强定点医疗机构监管的基本策略：明确政府管理部门的监管职能与职权，建设多层次、多主体参与的监管体系，开发监管手段和工具，注重监管效率、效益的提高。There are new requests and challenges about the supervision of the certified hospitals in the context of the construction of medical security system covering all residents in the urban and rural areas. We discuss the necessity of enforcing supervi- sion of the certified hospitals on the construction of medical security system covering all residents in the urban and rural areas. The necessity manifested mainly in these areas： the inevitable requirement about the transformation of government functions, the important means about the governabilty of medical services, the important measures about the protection of security fund. After that, we propose some measures as the strategies on enforcing supervision of the certified hospitals, such as： clearing the regulatory functions and terms of reference about the management bodies of the medical security system, building a multilevel and multi-agent system of supervision, developing instruments about supervision so as to improve efficiency and benefits.

关 键 词：医疗保障体系 定点医疗机构 监管 

分 类 号：R197[医药卫生—卫生事业管理] F842[医药卫生—公共卫生与预防医学]