我国医保医用耗材目录及支付管理政策分析  

Policy Analysis of Reimbursement Medical Consumables Catalogue and Payment Management in China

作　　者：张誉铮 王培蒙 贾梦婷 刘玥 王晓辉 李雪 王耀羚 李睿 肖非易 钟磊 高鑫 张晓路 顾雪非 郭武栋 Zhang Yuzheng;Wang Peimeng;Jia Mengting(Department of Medical and Health Technology Assessment and Innovation Development,China;不详)

机构地区：[1]国家卫生健康委卫生发展研究中心医药卫生技术评估与创新发展部,北京100044 [2]成都中医药大学药学院,四川成都611137 [3]大连医科大学公共卫生学院,四川大连116044 [4]天津市医疗保障局,天津300110 [5]吉林省职业病防治院,吉林长春130102

出　　处：《中国卫生经济》2025年第2期34-40,共7页Chinese Health Economics

摘　　要：目的:分析我国医保医用耗材管理政策现状,为开展医保医用耗材精细化管理提供参考依据。方法:通过政策三角模型和政策工具理论,对我国医保医用耗材目录及支付管理政策进行综合分析,涵盖政策的背景、内容、过程和参与者维度。结果:医保医用耗材政策工具使用频率不均衡,支付管理规则亟待细化,缺少患者等多利益相关方的参与。结论:需进一步加强医保医用耗材基础管理,完善医保医用耗材准入机制,探索分类支付标准制定及创新支付机制。Objective:To analyze the current situation of medical consumables management policy in China,and to provide a reference for the refined management of medical consumables.Methods:Through the policy triangle model and policy tool theory,it comprehensively analyzes the reimbursement medical consumables catalogue and payment management policy of medical insurance in China,covering the policy background,content,process,and participant dimensions.Results:The use frequency of medical consumables policy tools is not balanced,the payment management rules need to be refined,and the participation of multi-stakeholders such as patients is lacking.Conclusion:It is necessary to further strengthen'the foundational management of reimbursement medical consumables catalogue,improve the access mechanism of medical consumables for medical insurance,and explore the formulation of categorized payment standards and innovative payment mechanisms.

关 键 词：医用耗材 医保目录准入 医保支付管理 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R19-0