完善城乡医疗救助制度之探索——以广东省汕头市为例

Exploration on the Improvement of Urban and Rural Medical Assistance System:Taking Shantou City of Guangdong Province as an Example

作为构建多层次医疗保障和卫生服务体系的重要组成部分,城乡医疗救助制度对于缓解贫困群众就医难,实现病有所医具有重要意义。目前,医疗救助制度在运行过程中仍然存在一定的缺陷和不足。通过对汕头市城乡医疗救助制度分析,发现存在以下问题与不足:覆盖面窄、救助标准偏低、时效性差、筹资渠道狭窄,救助上限差异较大、管理体制不健全,缺乏相关法律法规约束等。完善医疗救助制度可以从全面实施普通门诊医疗救助、提高救助标准和报销比例、取消救助金额上限、推行医疗救助即时结算机制、拓宽筹资渠道等方面加以改善。

As an impornant part of multi-level medical security and health service system, urban and rural medical assistance system plays a very significant role in providing universal health care, especially for the poor. At present, the medical assistance system still exists some deficiencies in the process of operation. This paper drew a conclusion that there are system design issues ca medical assistance coverage, medical assistance level, effective time limitation, financing sources, relief ceiling, managenent system of the Shantou medical assistance system. It is urgent to implement the coverage of general outpatient medical assis ance, improve the reimbursement standard of medical assistance level, cancel the limitation amount of medical assistance, pop tlarize the immediate settlement mechanism and increase funding sources.