基本医疗保险基金和公共卫生服务资金协同视角下的重点慢性病治疗保障机制优化研究  

Optimization of important chronic diseases treatment protection mechanism from the perspective of basic medical insurance and public health services coordination

作　　者：陈昕阳 陈烨[1] 丁锦希[1] CHEN Xinyang;CHEN Ye;DING Jinxi(China Pharmaceutical University,Nanjing 211198,China)

机构地区：[1]中国药科大学,南京211198

出　　处：《上海医药》2024年第17期9-14,39,共7页Shanghai Medical & Pharmaceutical Journal

摘　　要：国家已明确提出要统筹基本医疗保险基金和公共卫生服务资金使用,实现公共卫生服务和医疗服务有效衔接,这对于提高我国慢性病治疗率和控制率、促进社会稳定具有重要意义。本文聚焦我国重点慢性病患者的待遇保障,梳理总结当前3种基本医疗保险基金和公共卫生服务资金协同保障模式,厘清协同保障治疗病种的特点和各协同保障模式的共性,分析存在的问题。建议在国家层面明确重点慢性病病种遴选标准并建立协同保障治疗的重点慢性病病种目录,同时通过灵活调整基本医疗保险报销比例和建立公共卫生服务资金长效筹资机制来提高协同保障机制的可持续性。At present,the national level has clearly proposed to“Coordinate the use of national basic medical insurance and public health funds,and realize the effective connection between public health services and medical services”,which is of great significance for improving the treatment rate and control rate of chronic diseases in China and promoting social stability.Focusing on the treatment and protection of important chronic diseases in China,we summarize the current three mainstream collaborative protection modes,clarifies the characteristics of collaborative protection diseases and the commonalities between the protection modes,and raise targeted questions,and suggest that the selection criteria of diseases should be clarified at the national level and a catalogue of core diseases should be formed to coordinate the protection of diseases.At the same time,the pressure on public health expenditure should be reduced by flexibly adjusting the reimbursement ratio of basic medical insurance and establishing a long-term financing mechanism.

关 键 词：慢性病 协同保障 待遇保障 

分 类 号：R197.1[医药卫生—卫生事业管理]