健康教育纳入我国社会医疗保险的可行性分析

Feasibility Analysis of Health Education into Social Medical Insurance in China

目的借鉴国内外成功经验,对健康教育纳入我国社会医疗保险模式的可行性进行分析。方法通过对国外健康教育与健康促进的相关经验进行总结,并结合借鉴我国目前已经开始进行的健康教育方式,研究健康教育纳入我国医保制度的方式方法。结果国外经验表明,采用健康教育可以大幅度降低医疗费用支出,我国也已经具备了相关的实践条件,由社区卫生服务机构牵头进行健康教育,并将这一方式纳入我国医疗保险。结论对慢性病及潜在慢性病患者进行健康教育,可以大幅度降低医疗费用支出,因此,社会医疗保险可以采用与社区卫生服务机构共建的健康管理模式,国家允许社会医疗保险的部分资金用于居民的健康管理,将社区健康管理纳入医疗保险制度的管理范围。

Objective To analysis the feasibility of health education into social medical insurance in China. Methods Through studying and summarizing the experience abroad in health education and promotion, and taking the existing health education mode at home for reference, to discuss the mode and method to take health education into the medical insurance in China. Results Overseas experience has showed that health education could reduce the medical expense greatly. Furthermore, the relevant conditions of practicing it now in China have had, or carrying out the health education mainly by community health service institutions, and make the program into social medical insurance. Conclusion Health education on chronic diseases and potential chronic diseases can greatly reduce the medical expense. So the social medical insurance may take the mode of health management by community health service institutions, and a part of fund in medical insurance should be allowed to spend on health education for community residents, which needs to be brought into the managing category of medical insurance system.