应用型委托代理理论下医保控费考核方法探索  

Exploring the Assessment Method of Medical Insurance Cost-Control under the Theory of Applied Entrusted Agent

作　　者：袁建平[1] 邹俐爱[2] YUAN Jian-ping;ZOU Li-ai(Guangzhou First People's Hospital,Guangzhou,510180,China;不详)

机构地区：[1]广州市第一人民医院,广州510180 [2]南方医科大学南方医院/卫生与健康管理研究院,广州510150

出　　处：《中国卫生经济》2022年第12期101-104,共4页Chinese Health Economics

摘　　要：医疗机构集双重代理人身份与医疗服务提供者于一体,具有绝对的信息优势,医保控费需要医疗机构及医务人员的主动配合。文章应用联合确定基数法,从医疗机构和机构内临床科室两个层面研究促进其积极主动参与医保控费的考核方法,提出了医疗保险机构同时对医疗机构医疗服务产品数量及其单价进行激励与约束的政策建议。Medical institutions have an absolute information advantage by combining dual agency status with that of a medical service provider.Medical insurance cost-control requires the proactive cooperation of medical institutions and medical staffs.The model of jointly deciding contract target is applied to study the assessment method of medical insurance cost-control that promotes the active participation from the aspects of medical institution and clinical department.Meanwhile,it puts forward some suggestion that medical insurance institution should encourage and constrain the quantity and price of medical institution.

关 键 词：联合确定基数法 医保控费 医疗服务产品 激励相容 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R197.323