多层次医疗保障体系下的惠民保险高质量发展研究  

High-quality development of Huimin Insurance under the multi-level medical security system

作　　者：朱欣叶 钱爱兵 时孝春[2] 梁晓玲[2] 阮智慧 Zhu Xinye;Qian Aibing;Shi Xiaochun;Liang Xiaoling;Ruan Zhihui(School of Health Economics and Management,Nanjing University of Traditional Chinese Medicine,Nanjing 210000,Jiangsu Province,China;Jiangsu Provincial Hospital of Traditional Chinese Medicine;Jiangsu Health Vocational College)

机构地区：[1]南京中医药大学卫生经济管理学院,南京210000 [2]江苏省中医院 [3]江苏卫生健康职业学院

出　　处：《中国医疗管理科学》2024年第3期3-8,共6页Chinese Journal Of Medical Management Sciences

基　　金：国家中医药管理局课题(ZYJGC-YSCW202010)。

摘　　要：目的推进惠民保险高质量发展进程,进一步完善多层次医疗保障体系。方法基于社会福利政策分析框架从分配基础、给付内容、输送机制和资金选择4个维度分析惠民保险的发展现状,进一步探究推进惠民保险高质量发展面临的挑战并据此提出相应政策建议。结果研究发现,推进惠民保险高质量发展过程中面临的潜在风险客观存在、地区发展不协调、政策性和营利性难以均衡、医保数据使用受限4大难题。结论建议加大风险管控力度,完善地区资源配置,发挥政企联动优势,加快数字化建设进程。Objective To promote the high-quality development of Huimin Insurance and further optimize the multi-level medical security system.Methods Based on the analytic framework for social welfare policy,the authors analyzed the Huimin Insurance from four dimensions:distribution basis,payment content,delivery mechanism,and funding options.Furthermore,the authors elucidated the challenges faced in promoting high-quality development of Huimin Insurance and proposed corresponding policy recommendations.Results The high-quality development of Huimin Insurance faced four major challenges:potential risks,poor inter-regional coordination,difficulty in balancing policy and profitability,and restricted use of medical insurance data.Conclusion Strengthened risk control,improved resource allocation,enhanced government-enterprise collaboration,and accelerated digitalization may facilitate the high-quality development of Huimin Insurance.

关 键 词：医疗保障体系 惠民保险 高质量发展 

分 类 号：R197[医药卫生—卫生事业管理]