安徽省县域医疗服务共同体新农合按人头总额预付制度初探  

Preliminary investigation of regional global per countywide medical service community in Anhui capita budget for medical payment system of province

作　　者：施利群[1] 陈迎春[1] 高红霞[1] 夏北海 雷诗寒 李浩淼[1] 刘露华 常静肼 苏岱 张慧[1] 

机构地区：[1]华中科技大学同济医学院医药卫生管理学院湖北省人文社科重点研究基地农村健康服务研究中心,武汉430030 [2]安徽省卫生和计划生育委员会

出　　处：《中华医院管理杂志》2017年第7期489-492,共4页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金（71473096,71673101）

摘　　要：介绍了安徽省新型农村合作医疗2015年起试点实行的县域医疗服务共同体按人头总额预付制度，分析了其作用机制，包括形成共同的目标激励约束机制，促进患者合理流动；形成良性的自我控费机制，减轻患者负担；构建高效的资源配置机制，促进机构共同发展。改革实施后，试点县住院患者流向趋于合理，患者就医负担减轻，医疗机构服务能力有所提升，可为我国其他地区支付方式改革提供借鉴。This paper analyzed and concluded successful experience and mechanisms of regional global per capita budget implemented since 2015 in Anhui province, including the formation of mutual incentive and restraint mechanism, the mechanism of controlling expenses spontaneously and resource allocation efficiently. After the reform, flow of hospitalized patients was more rational, and the financial burden of patients was alleviated, while the capacity of medical institutions was improved notably in pilot counties. The successful experience of Anhui province can put forward corresponding suggestions to guide the future work in other areas.

关 键 词：县域医疗服务共同体 支付制度 按人头总额预付 作用机制 安徽省 

分 类 号：F323.89[经济管理—产业经济] F842.684[医药卫生—卫生事业管理] R197.1[医药卫生—公共卫生与预防医学]