纳入门诊大病统筹的病种分析:以江苏省为例  

Analysis of Outpatient Serious Disease Covered by Risk-pooling Fund: Taking Jiangsu Province as an Example

作　　者：周绿林[1] 吴悦[1] 詹长春[1] 

机构地区：[1]江苏大学管理学院公共卫生事业管理系,江苏镇江212013

出　　处：《中国卫生经济》2013年第1期45-46,共2页Chinese Health Economics

基　　金：国家社会科学基金项目(12BGL110);教育部人文社科规划项目(09YJA840013)

摘　　要：文章以江苏省6市为例,分析了2011年纳入统筹基金支付的门诊大病病种以及几类门诊大病的患病、费用与统筹支付情况,发现建立门诊大病统筹支付制度可以较好地解决门诊大病高额医疗费用所带来的负担问题,也减少了"门诊挤住院"费用情况的发生。为使得统筹基金能发挥最大的效用,建议完善相关政策,合理选择门诊大病病种、合理设置起付线与封顶线。The article analyzes outpatient serious disease covered by risk-pooling fund as well as sicking suffering, expenses and reimbursement of several outpatient diseases in six cities of Jiangsu Province in 2011. It is found that establishing outpatient reimbursement system can effectively solve burden problem brought by high medical cost of chronic disease and reduce the ＂outpatient crowds hospital＂ case. To make risk-pooling fund to maximum effect, It is suggested to make the necessary perfection in policy on selection of outpatient serious disease as well as setting up pay line and top line.

关 键 词：门诊大病 病种选择 统筹支付 

分 类 号：R197.1[医药卫生—卫生事业管理]