基于文献计量分析的总额预付医保支付模式效果研究  

Research of Effectiveness of Global Budget Medical Insurance Payment System Based on Bibliometrics Analysis

作　　者：朱妍 丁文裴 唐文熙[1] ZHU Yan;DING Wen-pei;TANG Wen-xi(School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing,Jiangsu,211198,China)

机构地区：[1]中国药科大学国际医药商学院

出　　处：《中国医院管理》2020年第2期11-14,共4页Chinese Hospital Management

基　　金：国家自然科学基金青年科学基金项目(71603278);中国药科大学青年教改专项(2017XJQN32);大学生创新创业训练计划项目(201910316179)

摘　　要：目的对我国不同地区实行总额预付的效果进行总结,归纳总额预付医保支付模式在我国的适应性及改革方向,并提出相关政策建议。方法采用文献计量分析法,检索数据库为中国知网、万方数据,制定纳入排除标准对检索所得文献进行筛选,对文献内容及不同省市区案例进行分析总结。结果总结归纳总额预付在各地实践过程中的成效以及出现的问题。结论一是通过加强对医疗机构的监管,严格限制不良医疗行为发生;二是提高医院管理水平,利用精简机构、绩效考核等方式,降低成本并提高服务质量;三是加强分级诊疗制度的宣传和推行力度,以减轻三甲医院的预算压力。Objective By summarizing the medical insurance policy in China and summarizing its effect according to the empirical cases in different provinces,to conclude the adaptation and reform orientation of global budget medical insurance payment model,in order to provide suggestions on medical payment system.Methods Using the bibliometric analysis through searching relevant literature in CNKI and WanFang data,establishing inclusion and exclusion criteria to screen the retrieved literature,and analyzing the literature content,summarizing the empirical cases of different provinces.Results The effectiveness and problems of global budget in the process of practice in various places are concluded.Conclusion It suggested to improve medical insurance payment system by strengthening supervision,improving management level and reducing costs and improving service quality,and strengthening the propaganda and implementation force of hierarchical diagnosis and treatment to reduce the budget burden of tertiary hospital.

关 键 词：支付方式 医疗保险 总额预付 文献计量分析 

分 类 号：R197.1[医药卫生—卫生事业管理]