我国门诊医保支付方式对比研究  

A Comparative Study of Outpatient Medical Insurance Payment Methods in China

作　　者：周璇 黄琇棠 唐东锋 邱亨嘉 ZHOU Xuan;HUANG Xiutang;TANG Dongfeng;QIU Hengjia(Institute for Hospital Management,Tsinghua University,Shenzhen Guangdong 518055,China;不详)

机构地区：[1]清华大学医院管理研究院,广东深圳518055 [2]霍普金斯大学公共卫生学院,美国巴尔的摩MD4321

出　　处：《卫生经济研究》2022年第11期19-22,共4页

基　　金：深圳市门诊医保付费机制研究项目“深圳市门诊医保付费机制研究”(MHSB-202012-0011)。

摘　　要：选取首创门诊病例分组(APG)支付方式的金华市和以“就诊人头”和“病种人头”支付方式为特色的镇江市,对其全科门诊、专科门诊和门诊慢性病医保支付方式进行对比分析,梳理各自的优势与局限,探讨不同门诊服务类型的最适宜支付方式,为完善门诊医保复合支付方式提供思路。Jinhua City, which pioneered the outpatient case grouping(APG) payment method, and Zhenjiang City, which features the "headcount of visit" and "headcount of disease" payment methods, were selected to compare their general outpatient, specialist outpatient and outpatient chronic disease health insurance payment methods. This paper compared the advantages and limitations of each model and explored the most appropriate payment methods for different types of outpatient services to provide ideas for improving the composite payment method for outpatient health insurance.

关 键 词：医疗保险 支付方式 门诊 

分 类 号：F840.684[经济管理—保险]