美国管理型医疗保健模式及其对我国医疗保健制度改革的启示

American managed health care model and its enlightenment to the health care system reform in China

从美国管理型医疗保健的概念界定入手,介绍了管理型医疗保健的四种基本模式,从补偿机制、利用评审、质量保证三个角度阐述了它的运作方式,指出管理型医疗保健对我国医保改革的借鉴意义。

With the concept of American managed health care being identified, its four basic models are introduced, describing the operational pattern in terms of compensation scheme, applying review and quality assurance. It suggests that in China the health care insurance reform should be inspired from the American managed model.