摘要
目的梳理我国整合医疗卫生服务实践中所采取的主要激励举措,识别取得的成效和存在的问题,并提出优化策略。方法采用文献复习、政策梳理以及关键知情人访谈等研究方法,对不同类型的整合医疗卫生服务模式开展研究。结果目前财政对整合医疗卫生服务的投入以项目为主,缺乏常态机制。医疗保险仍以单体机构、后付制为主,医疗联合体支付突破难。部分人员激励机制缺乏政府政策支持。结论政府层面可通过建立整合医疗卫生服务财政专项的形式来落实保障经费;医疗保险支付从机构总额控制向区域总额控制转变;完善绩效工资内部分配,纳入整合医疗卫生服务指标。
Objective To summarize the main incentivize mechanisms adopted in Chinese integrated care practice,identify major achievements as well as problems,and put forward improving strategies.Methods Research on different types of integrated care models was studied based on literature review,policy review,and key informant interviews.Results Financial investments in integrated care were mainly project-centered,lacking routine mechanism.Medical insurance payment was still dominated by fee-for-service and other post-payment methods.Some personnel incentivize methods lacked support from government policies.Conclusion Special subsidy can be established at the government level to ensure the implementation of integrated care.It is suggested that medical insurance payment be focused on regional payment instead of institutional payment.It is also proposed that internal distribution of salaries be improved and incorporate integrated care indicators.
作者
朱碧帆
李芬
陈多
王常颖
顾淑玮
金春林
ZHU Bi-fan;LI Fen;CHEN Duo;WANG Chang-ying;GU Shu-wei;JIN Chun-lin(Shanghai Health Development Research Center(Shanghai Medical Information Center),Shanghai 200040,China;School of Economics and Management,Jiangxi University of Traditional Chinese Medicine,Nanchang 330000,Jiangxi China)
出处
《中国卫生资源》
北大核心
2019年第6期410-414,共5页
Chinese Health Resources
基金
国家卫生健康委员会委托项目“整合型医疗卫生服务体系框架及典型地区研究”(2018008B)
关键词
整合医疗卫生服务
筹资
激励机制
优化策略
医疗保险支付
integrated health care
financing
incentivize
optimizing strategy
payment of medical insurance
