新三医联动模式下的医疗体制改革探讨

Exploration on Medical System Reform under the New Tripartite System Reform

医疗服务体制机制改革是新三医联动模式的重要内容。笔者依据卖方花钱办事理论分析了医疗保险付费方式的激励机制、与医疗保险付费方式适配的医疗服务体制机制及医疗服务体制机制的改革方向,认为公立性行政化医疗服务体制机制既能弥补后付费方式抬高医疗费用的缺陷,又能弥补后付费方式诱发医疗风险的缺陷;法人化竞争性医疗服务体制机制既能发挥预付费方式控费的优势,又能弥补预付费方式降质的缺陷,以此为新三医联动模式下的医疗服务体制机制改革提供理论参考。

The medical service system and mechanism reform is the important content of the New Tripartite System Reform model. According to the ＂seller＇ s spend - money and handle - affairs＂ theory ,we analyzed the incentive mechanism of medical insurance payment mode, the medical service system and mechanism adapting to medical insurance payment mode, and reform direction of medical service system, and put forward the conclusion that public - administration medical service system not only can make up for the defects of lifting fees of the post - paid, but also can make up for the defects of the post - paid inducing risk; and corporate - competitive medical service system not only can take advantage of the prepaid control fee, but also can make up for the defects of the prepaid reducing quality, to provide theoretical reference for medical service system reform under the New Tripartite System Reform model.