医保支付机制对社区医疗体系影响作用研究——基于南京市部分社区的调查  

Influence of medical insurance payment mechanism on community health care system—— a research of communities in Nanjing

作　　者：茅宁莹[1] 宋丽华[1] 夏小倩[1] 姚云比 黎晓薇[1] 王香怡 乔羽佳[1] 郑子健[1] 

机构地区：[1]中国药科大学国际医药商学院,江苏南京211198

出　　处：《中国医院药学杂志》2016年第18期1537-1541,共5页Chinese Journal of Hospital Pharmacy

摘　　要：我国医疗保险支付制度对医疗资源的配置、规范和引导医疗服务提供方行为的作用日益显著,也在很大程度上影响了社区卫生服务机构的发展。本文阐述了医保支付机制对社区医疗发展的正负效应,然后基于对南京市部分社区的居民、社区医疗机构工作人员的访谈与调查,总结社区医疗不同参与方的观点与建议,对当前医保支付机制与社区医疗发展之间的矛盾及其原因进行了分析,并对未来如何通过改进医保支付机制来促进社区医疗的发展提出建议。The medical insurance payment system plays an increasingly significant role in configuration of medical resources,standardization and guidance of behaviors of medical service providers,and influences development of community health service institutions to a large extent.This paper reveals positive and negative influences of medical insurance payment mechanism in development of community health care,and summarizes opinions from different participants of community healthcare based on survey on residents and working staff in health service institutions in several communities.Finally,contradictions between payment mechanism and development of community health service are analyzed,and proposals are put forward on how to reform payment mechanism to promote development of community health services.

关 键 词：医保支付机制 社区医疗 医保政策 发展建议 

分 类 号：R969[医药卫生—药理学]