医保总额预付制下上海市三级医院应对行为理论分析

Theoretical analysis on the behavior change of tertiary hospitals under global budgeting in Shanghai

上海自2009年启动三级医院医保总额预付改革试点,并于2011年起推广到全市所有三级医院。本文围绕三级医院的经济运行,结合上海卫生系统的宏观环境,梳理分析总额预付制下上海市三级医院可能的应对行为,明确医保总额预付制下的政府监管重点,为相关政策体系的进一步完善和健全提出建议。

The piloting of global budget in Shanghai Health Insurance System was implemented in 2009, and all of the tertiary hospitals were covered since 2011. This article was to analysis the potential behavior change of tertiary hospitals under global budgeting based on the situation of hospitals' economic operation framework and the macro environment of Shanghai health system, so as to provide suggestion for further improvement of regulation.