山东省新型农村合作医疗运行中的问题及对策  

Problems and Suggestions of the New Rural Cooperative Medical System in Shandong Province

作　　者：武东霞[1,2] 

机构地区：[1]山东中医药大学人文社科学院,济南250355 [2]山东大学马克思主义学院,济南250100

出　　处：《医学与社会》2015年第8期37-39,共3页Medicine and Society

基　　金：2014年山东省软科学研究计划项目"山东省城乡居民医疗保险制度整合研究";编号为2014RKB14177;2013年山东省人文社会科学课题"山东省医疗保障的城乡差异及统筹改革研究";编号为13-ZZ-SH-05

摘　　要：2003年以来,山东省新型农村合作医疗取得了很大成就,但仍存在一些深层次的问题:碎片化的制度设计损害了医保公平和效率,医保统筹层次低、医保超支严重、经办机构服务能力低、医疗行为不规范、医疗服务质量有待提升等影响了医保效果。应该通过城乡医保一体化、建立控制医疗费用干预机制、加强经办机构资源能力建设、加强监督和管理、改善农村卫生服务质量等多种政策和措施来促进这一制度健康发展。Though the new rural cooperative health system in Shandong Province has achieved a lot since 2003, there are still some issues of this system, such as the segmentation of system design, low level of uniform arrangement, serious over cost, low ability of running agencies, non - standard medical behavior and pending improvement of medical service quality. In order to make it develop smoothly, the government should set up a system of urban - rural integration, control the medical expenses, strengthen the construction of agency and resource capacity, strengthen the supervision and administration and improve the quality of rural health service.

关 键 词：合作医疗 医保费用 医疗服务 监管 

分 类 号：R197.1[医药卫生—卫生事业管理]