医保政策与健康伦理的冲突与对策分析  

Analysis of the Conflict and Countermeasures between Medical Insurance Policies and Health Ethics

作　　者：侯慧玉[1] 王建斌[1] 刘雪云[2] 王亚珍[1] HOU Huiyu;WANG Jianbin;LIU Xueyun;WANG Yazhen(Medical Insurance Management Office,Hebei General Hospital,Shijiazhuang 050051,China;Organization and Human Resources Department,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院公费医保办公室,河北石家庄050051 [2]河北省人民医院组织人事处,河北石家庄050051

出　　处：《医学与哲学》2024年第20期35-38,共4页Medicine and Philosophy

基　　金：2024年河北省医疗保障研究课题(JYB240306)。

摘　　要：针对现行医保政策与患者健康伦理的冲突现象进行原因分析,汇总原因如下:医保基金的可持续发展状况堪忧、医保管理体系有待完善、医保管理部门与医疗机构协商谈判机制不健全、医疗卫生资源配置和人民群众的卫生服务需求不匹配。针对上述原因,应从调整医保基金筹资机制、构建多层次医疗保障体系、健全医保管理体系、建立医保管理部门与医疗机构协商谈判机制、促进医疗机构精细化管理程度等方面入手,维护医保基金安全,提高患者就医满意度。The reasons for conflicts between current medical insurance policies and health ethics of patients are analyzed,and the reasons are summarized as follows:the sustainable development of the medical insurance fund is worrying,the medical insurance management system needs to be improved,the consultation and negotiation mechanism between the medical insurance management department and hospitals is not sound,and the allocation of medical resources does not match the health service needs of the people.To address these issues,strategies should include adjusting the health insurance fund financing mechanism,building a multi-tiered healthcare security system,improving the health insurance management system,establishing negotiation mechanisms between insurance departments and medical institutions,and promoting refined management within medical institutions.These measures will help safeguard the health insurance fund and enhance patient satisfaction with medical care.

关 键 词：健康伦理 医保支付方式改革 带量采购 

分 类 号：R-05[医药卫生]