医疗保险监督的策略探讨

An Investigation of Supervisory Strategy in Medical Insurance

医疗保险的监督在医改的实际运作中起着越来越重要的作用。对医疗保险投保、医院服务、医保基金等方面监督策略的正确与否，一定程度上决定着医改的成败。本文结合深圳市６年医改工作实际，列出了影响医疗保险覆盖面的主要因素，介绍了深圳市对医疗保险服务进行监督的经验，并对医保基金运作的监督策略作了分析。作者认为，运用医疗保险计算机网络系统进行监督。

The supervisory strategy is playing an increasing important role in the reform of medical insurance. The policy of supervising insurance applications, medical service and insurance funds should be formulated carefully. In this paper, some influencing factors on the coverage of medical insurance are set out, and the experiences of 6 years reform in Shenzhens medical insurance are introduced. The methods of how to supervise the funds utilization in medical insurance also are explained. The author thinks that computer metwork is the best way to supervise medical insurance.