我国实现全民健康覆盖目标的策略建议

Strategies to achieve universal health coverage in China

文章介绍了全民健康覆盖的由来和目标,从服务覆盖、人口覆盖和费用覆盖三个方面对其内涵进行了阐述。从国外探索实现全民健康覆盖的实践,谈到我国推进全民健康覆盖的进展和存在的几个突出问题,包括卫生资源总量不足、配置不均衡;不同医保制度间医疗费用和服务利用不公平;基层医疗卫生机构服务能力有限,患者就医流向趋高。针对我国存在的问题,借鉴国际经验,建议加大卫生投入,重点加大对农村、中西部地区的财政转移支付力度;加强基层医疗卫生机构服务能力建设;建立基层首诊、分级诊疗、双向转诊的就医制度;提高基本医疗保险保障水平,整合医保体系。

This paper introduces the origin and objective of universal health coverage （UHC）, explains the connotation and significance of UHC from three aspects, including service-, population- and cost-coverage. Then, we introduce the practice of pursuing UHC by a variety of foreign countries, presents the progress of promoting UHC in China and the main problems in the process, including the lack and unbalanced allocation of health resources;unfairness of medical costs and utilization of health service between different medical insurance systems; the limited service capacity of primary health care institutions which causing the visiting level promoted. Aiming at these problems, several strategies are put forward to achieve UHC based on the current policy in China and with the experiences and lessons learned from foreign countries. For example, increasing investment in health, especially increasing financial transfer payment in rural areas and the Midwest region;strengthening the capacity building of primary health care institutions; establishing hierarchical diagnosis system;improving the level of security of basic medical insurance and integrating health care system.