组建以医保总量为纽带的医疗集团 提高区域卫生资源整合效率

Establishment of a Medical Group Linked by Annual Budget of Medical Insurance in order to Improve the Efficiency of Regional Health Resource Integration

医疗机构集团化是整合区域医疗卫生资源的有益尝试;包括预算控制在内的医保管理现行政策,是有效利用有限医疗资源、防范医保基金风险的监管措施。两者相互制约、相互依存,当两者协调发展,就会形成合力。文章提出一种既能发挥规模效应,又能灵活利用、有效控制医保基金的新型医疗集团模式,旨在为区域卫生规划的科学发展提供参考。

To establish medical groups is a helpful attempt to integrate regional medical resources. The existing policy of medical insurance management as budget control is a regulatory measure to effectively use the limited medical resources and guard against the risk of medical insurance fund. Restraining and depending on each other, these two will produce the powerful force while developing in harmony. With a view to provide reference for scientific development of regional health planning, this essay explored to establish a new - type medical group, which not only took large - scale effect, but also used medical insurance fund flexibly and effectively.