医保支付和经济激励:整合的医疗服务系统形成的“引擎”  

Medical Insurance Payments and Economic Incentive: The “Engine” of Forming Integrated Medical Service System

作　　者：魏来[1] 唐文熙[1] 孙晓伟[1] 张亮[1,2] 

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,武汉430030 [2]湖北省农村健康服务研究中心,武汉430030

出　　处：《中国卫生经济》2013年第5期35-38,共4页Chinese Health Economics

基　　金：国家自然科学基金(71273099)

摘　　要：整合的医疗服务系统的基本内涵是在合适的费用激励约束下促成组织结构整合、服务合作机制建立及其医务人员行为互动而形成的一种动态均衡状态。本文在揭示目前我国医疗服务主体存在非整合行为主要问题的基础上,通过美英澳等国案例分别从组织结构整合、医师行为转变和病人就诊规制3个方面梳理了促进医疗服务系统整合的循证依据。最后还指出要保证这项措施的成功应注意其本身的科学设计与共享的保健路径、有效的评估机制以及其他措施有机结合,实施系统的政策安排。The basic connotation of integrated delivery system （IDS） is to form a dynamic equilibrium that facilitates organization structure integration, service cooperation mechanism and its medical personnel interaction under the appropriate economic incentive and constraint. Based on the problems of nonintegrated behavior of the current medical service in China, it finds evidence-based literature to improve service system integration respectively from organization structure integration, physicians clinical behavior change and patients＇ care-seeking regulation through the cases of the US, British and Australia and so on. In order to ensure the success of payments and economic incentive, it finally points out that organically combining its own scientific design with shared care path and effective evaluation mechanism and other measures, implementing the systematic policy arrangement are needed.

关 键 词：支付机制 预付制 经济激励 整合的提供系统 

分 类 号：R197.1[医药卫生—卫生事业管理]