浙江省医疗保险基金付费方式改革研究  

Research on the Reform of Medical Insurance Fund Payment in Zhejiang Province

作　　者：余祖伟[1] 胡宏伟[2] YU Zu-wei HU Hong-wei(Ningbo University of Technology, Ningbo Zhejiang 315211, China North China Electric Power University, Baoding Hebei 071003, Chin)

机构地区：[1]宁波工程学院经济与管理学院,浙江宁波315211 [2]华北电力大学人文与社会科学学院,河北保定071003

出　　处：《襄阳职业技术学院学报》2017年第3期92-95,126,共5页Journal of Xiangyang Polytechnic

基　　金：国家社会科学基金项目(11CGL072);浙江省人力资源和社会保障课题(2016092)

摘　　要：医疗保险基金付费方式的完善是深化医药卫生体制的重要组成部分。在阐明研究背景同时,文章系统分析了医疗保险基金付费方式存在的各类问题,并提出了复合式付费制度的系统思路,即通过摸底阶段、制度改革阶段和统筹实现阶段三个步骤,以逐步整合资源,建立以DRGs为基础的病种分类付费模式,在控制总额医疗费用的基础上提升医疗服务质量和水平。The improvement of medical insurance fund payment is an important part of deepening the medical and health system. In the process of clarifying the research background, this paper systematically analyzes the various problems of the payment method of medical insurance fund, and puts forward the systematic thinking of the compound payment system, namely, through the three steps of thoroughly understanding the stage, system reform stage and overall realization stage. From gradually integrating resources and the estab- lishment of a DRGs-based disease classification payment vices and level on the basis of controlling the total cost of model, we can improve the quality of medical sermedical care.

关 键 词：医疗保险基金 付费方式 诊断相关分类 

分 类 号：F842[经济管理—保险]