功能与能力匹配视角下我国基本医疗保障制度高质量发展路径探索  

Exploration of the High-Quality Development Path of Chinas Basic Medical Security System from the Perspectiv of Matching Functions and Capabilities

作　　者：吴蓉 赵云[1,2] 庞庆泉 Wu Rong(Youjiang Medical University for Nationalities,Baise,P.R.China)

机构地区：[1]右江民族医学院,广西百色533000 [2]徐州医科大学

出　　处：《中国卫生事业管理》2024年第1期40-44,共5页Chinese Health Service Management

基　　金：国家社会科学基金项目“健康治理视角下公共卫生、医药服务与医疗保障的三位一体融合协同机制研究”(21XGL018)。

摘　　要：全面深化医疗保障制度改革,实现医疗保障高质量发展关键在于全面建成多层次医疗保障体系。基本医疗保障作为多层次医疗保障体系的核心内容,在社会主要矛盾发生变化的形势下,出现了功能与能力不匹配的严峻问题。文章深入剖析了基本医疗保障高质量发展面临的外部需求挑战和内部能力制约,切实提出了推进基本医疗保障高质量发展的实现路径,即按“二十大”要求推动多层次医疗保障体系的建设,将协同治理引入医疗保障制度改革,既最优化发挥基本医疗保障的核心功能,也最大化发挥商业健康保险的重要功能。并以此为基础,针对功能与能力不匹配提出三种破解途径,并按照全面深化医疗保障制度改革“1+4+2”框架提出推进基本医疗保障高质量发展的制度框架,为新时期医疗保障制度深化改革提供有价值的建议。Comprehensively deepening the reform of medical security system and realizing the high-quality development of medical security lies in the comprehensive establishment of a multi-level medical security system.As the core content of multi-level medical security system,basic medical security has a serious problem of mismatch between function and ability under the changing situation of social principal contradiction.The external demand challenges and internal capacity constraints faced by the high-quality development of basic medical security were analyzed,and the realization path to promote the high-quality develop-ment of basic medical security was put forward,which were promoting the construction of a multi-level medical security system,and introducing collaborative governance into the reform of medical security system.Based on which,three ways to solve the mis-match between functions and capabilities were proposed,and an institutional framework for promoting the high-quality develop-ment of basic medical security was proposed in accordance with the"1+4+2"framework for comprehensively deepening the re-form of medical security system.

关 键 词：基本医疗保障 多层次医疗保障 协同治理 高质量发展 

分 类 号：R197.3[医药卫生—卫生事业管理]