台湾地区全民健保支付方式改革研究及启示  

Research and enlightenment on payment method of national health insurance reform in Taiwan

作　　者：石朗敏 冯国忠[1] SHI Lang-min;FENG Guo-zhong(China Pharmaceutical University,Nanjing Jiangsu 211198,China)

机构地区：[1]中国药科大学,江苏南京211198

出　　处：《卫生软科学》2020年第11期81-84,共4页Soft Science of Health

基　　金：江苏省研究生科研创新基金(KYCX20_0695)。

摘　　要：通过文献梳理,介绍了中国台湾地区实施全民健保后支付方式改革的历程,分析其支付方式的设计和改革的特点,并提出大陆地区应该完善法律体系、明确部门职责、循序渐进推行改革;发挥医药协会及专家组织作用,建立合理的协商决策机制;积极探索绩效支付,提升医疗服务品质;因地制宜,探索本土化的医保支付方式等建议,以期为大陆地区医疗保险支付方式改革提供参考。This article introduces reform process of payment method reform after implementing national health insurance in Taiwan,and analyzes the design of payment method and reform characteristics through teasing literature.It puts forward suggestions such as improving law system,clear-cutting department responsibility,promoting the reform step by step,playing organizational function of medical associations and experts,establishing reasonable negotiation decision-making mechanism,actively exploring performance payment,improving the quality of medical services,adjusting measures to local condition and exploring local payment method of health insurance,so as to provide reference for payment method reform of health insurance in mainland.

关 键 词：医疗保险 支付方式 论质计酬 Tw-DRGs 台湾地区 

分 类 号：R-01[医药卫生] F840.684[经济管理—保险]