医保助推分级诊疗的对策与思考——基于重庆的实践

Thought and Countermeasure of Promoting the System of Tiered Medical Services by Basic Medical Insurance——Based on the Practice of Chongqing

从目前来看,医疗服务总体呈现倒金字塔模式,分级诊疗体系建设面临的核心问题是稀缺医疗资源的优化配置。要想顺利实施分级诊疗制度,需要医保杠杆与强基层并举,促进医疗资源合理向基层配置。重庆市通过医保协议管理、医保服务供给和推进公立医疗机构改革等措施,着力推进优质医疗资源下沉,提高基层医疗机构供给能力,充分发挥医保的引导作用,助推分级诊疗实施。

From the current point of view, the overall medical service showed inverted Pyramid model. The core problem of the construction of tiered medical services system is the optimal allocation of scarce medical resources In order to successfully implement the tiered medical services system, we need to play the role of medical insurance leverage and strengthen the community, to promote the rational allocation of medical resources to the community. Through the management of medical insurance agreement, the supply of medical service and the reform of public medical institutions, Chongqing eff orts to promote the sink of high-quality medical resources, improve the supply capacity of primary medical institutions, give full play to the guiding role of medical insurance,and boost the implementation of tiered medical services.