健全职工基本医疗保险门诊共济保障机制刍议  

Improving the Mutual Assistance Mechanism for Outpatient Services as Part of Employees’Basic Medical Insurance

作　　者：王薇 WANG Wei(Tangshan Medical Insurance Service Center,Tangshan 063000,China)

机构地区：[1]唐山市医疗保险服务中心,河北唐山063000

出　　处：《唐山师范学院学报》2025年第1期102-105,共4页Journal of Tangshan Normal University

摘　　要：职工基本医疗保险在运行过程中面临部分重大疾病和特殊病种的保障力度不足,医保基金的收支平衡存在一定的可持续性风险,医疗服务的质量和效率有待提升等诸多挑战。对此,应完善基本医疗保险政策体系,强化医保资金管理,从而健全职工基本医疗保险的门诊共济保障机制,满足人们对于医疗保障日益增长的需求。In the operation of basic medical insurance for employees,there are challenges such as insufficient coverage for certain major and special diseases,certain sustainability risks in the balance of medical insurance funds,and the need to improve the quality and efficiency of medical services.In response to these challenges,it is necessary to improve the basic medical insurance policy system,strengthen the management of medical insurance funds,thereby enhancing the mutual assistance mechanism for outpatient services as part of employees’basic medical insurance and fulfilling the ever-growing demand for medical security among people.

关 键 词：职工基本医疗保险 门诊共济 保障机制 

分 类 号：F84[经济管理—保险]