发达县域居民跨省异地就医成因与优化策略探析  

Causes and optimization strategies of cross-provincial medical treatment for residents in developed counties

作　　者：朱晓强[1] 高恒[1] 张华[1] 许兴龙 江昱成 Zhu Xiaoqiang;Gao Heng;Zhang Hua;Xu Xinglong;Jiang Yucheng(Jiangyin People′s Hospital,Southeast University School of Medicine,Jiangyin 214400,China;School of Management,Jiangsu University,Zhenjiang 212013,China)

机构地区：[1]东南大学医学院附属江阴医院,江阴214400 [2]江苏大学管理学院,镇江212013

出　　处：《中华医院管理杂志》2023年第10期795-798,共4页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金(72274081)。

摘　　要：跨省异地就医能够满足居民高质量健康需求,弥补欠发达地区优质医疗资源不足的困境。但在经济发达、医疗资源较为丰富的地区,也存在居民跨省异地就医较为突出的现象。作者以苏南县域J市为例,通过实地走访调查,了解J市2017—2021年跨省异地就医人次、费用及病种分布情况。并结合深度访谈,探讨J市居民跨省异地就医成因,包括长三角健康一体化进程有效推进、当地医疗技术水平有待提升、医保政策并不完善、大病保险报销比例相对较低等。并提出打造本土医疗品牌特色、提升公立医院医疗技术水平、改革完善医保报销政策等策略建议。Cross-provincial medical treatment can meet the high-quality health needs of residents and make up for the shortage of high-quality medical resources in underdeveloped areas.However,in economically developed areas with abundant medical resources,the phenomenon of residents seeking medical treatment across provinces was prominent.The author took J City as an example to present the distribution of cross-provincial medical visits,costs,and disease types in J City from 2017 to 2021 through on-site visits and surveys.Combined with in-depth interviews,the causes of residents in J city seeking cross-provincial medical treatment were explored,including the effective promotion of health integration in the Yangtze River Delta,the need to improve local medical technology,incomplete medical insurance policies,and relatively low reimbursement rates for major illness insurance.And strategic suggestions were proposed,including building local medical brand,improving the medical technology level of public hospitals,and reforming and improving medical insurance reimbursement policies.

关 键 词：卫生服务研究 发达县域 跨省异地就医 基本医疗保险 成因 策略 

分 类 号：R197.1[医药卫生—卫生事业管理]