国外医保支付报销政策对我国基本药物合理使用的启示  

The Enlightenment of Foreign Medical Insurance Payment Reimbursement Policy to Rational Use of Essential Medicines in China

作　　者：王珩[1] 徐舒曼[2] 陆华[2] 吴静雅[2] 

机构地区：[1]安徽医科大学第四附属医院,安徽合肥230022 [2]安徽医科大学卫生管理学院,230032

出　　处：《中国执业药师》2013年第5期69-73,共5页China Licensed Pharmacist

基　　金：药物政策与基本药物制度司2012年委托课题(医疗机构优先使用基本药物鼓励政策研究);教育部人文社会科学研究一般项目(12YJA630121);安徽省软科学研究项目(12020503084)

摘　　要：基本药物制度的实施过程离不开政策支持和各方配合,作为医疗卫生消费领域的第三方支付机制,医疗保险制度通过其独有的政策杠杆作用,在很大程度上影响着基本药物制度在医疗机构的实施效果。目前,我国的基本药物医保报销政策尚不完善,难以真正促进基本药物的优先使用。本文参考了国外医保支付报销政策的先进经验和有力做法,在此基础上结合我国的现状,对医保政策提出了一些针对性的建议和意见。The implementation process of essential medicine system is a result of policy support and various coordination. As a third-party payment mechanism in the field of medical and health consumption, the medical insurance system which has its unique policy leverage significantly influences the implementation effect of the essential medicine system in medical institutions. At present, because of the imperfection of medical insurance reimbursement policy of essential medicines in China, there is a difficulty to promote the preferential use of essential medicines. Referring to the foreign advanced experiences of the medical insurance payment reimbursement policy and the effective approaches, and based on the current situation of our country, proposals and opinions related to the medical insurance policy were raised in this article.

关 键 词：基本药物 国外药品报销政策 启示 医疗保险制度 

分 类 号：R197.32[医药卫生—卫生事业管理]