从城乡居民医保住院费用流向看紧密型县域医共体的建设  

On the construction of tight county medical community from the flow of medical insurance and hospitalization expenses of urban and rural residents

作　　者：胡晓先[1] HU Xiaoxian(Feixi County Center for Disease Control and Prevention,Feixi,Anhui 231200,China)

机构地区：[1]安徽省肥西县疾病预防控制中心,安徽肥西231200

出　　处：《中国农村卫生事业管理》2020年第2期106-108,共3页Chinese Rural Health Service Administration

摘　　要：医保基金按人头总额预付,交由医共体包干使用,是县域医共体建设的杠杆。文章通过对肥西县城乡居民住院患者流向及基本医保资金支出实证分析,认为紧密型县域医共体建设实施过程中应避免补偿标准与付费政策的矛盾、实行精细化分级诊疗、提升县域医疗服务能力、发挥医联体作用。The medical insurance fund for urban and rural residents is paid in advance according to the population, and is used by the medical community as a whole, which is the lever for the construction of the county medical community. Based on the empirical analysis of the flow direction of inpatients and the expenditure of basic medical insurance funds for urban and rural residents in Feixi County, this paper draws some enlightenment: in the process of the construction and implementation of tight county medical community, it is necessary to avoid the contradiction between the compensation standard and the payment policy, implement the refined hierarchical diagnosis and treatment, improve the county medical service capacity, and play the role of Medical Association.

关 键 词：紧密型县域医共体 城乡居民基本医保 按人头总额预付 

分 类 号：R19[医药卫生—卫生事业管理]