“N+X”政策背景下江苏省13个统筹区门诊特殊病政策比较研究  

Comparative Study on Outpatient Special Disease in 13 Coordinated Regions of Jiangsu Province under the“N+X”Policy

作　　者：裘怡津 查镜凯 周挺 Qiu Yijin;Zha Jingkai;Zhou Ting(China Pharmaceutical University,Nanjing,Jiangsu,211198,China;不详)

机构地区：[1]中国药科大学,江苏南京211198

出　　处：《中国医院管理》2024年第7期21-25,共5页Chinese Hospital Management

摘　　要：以门诊特殊病病种范围、保障水平及定点管理为切入点,在江苏省“N+X”政策背景下,对全省13个统筹区新出台的门诊特殊病相关政策进行梳理,探索各统筹区门诊特殊病管理的异同之处及现存的问题,并提供相关建议。江苏省发布了统一基本医保门诊特殊病保障政策的指导性文件,但各统筹区病种范围、保障水平的差异仍不容忽视,或将影响患者公平,阻碍全省统一的门诊特殊病病种制度建立。各统筹区在病种遴选、分级诊疗及门诊特殊病认定等方面也存有改善空间。建议在后续管理中建立全省统一的病种动态遴选机制、发挥好基层医疗卫生机构的作用、完善门诊特殊病认定标准。Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the“N+X”policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

关 键 词：门诊特殊病 政策 病种遴选 江苏 

分 类 号：R197.1[医药卫生—卫生事业管理]