西藏城乡居民基本医疗保险制度并轨问题探讨

Study on the Integration of Basic Medical Insurance System for Urban and Rural Residents in Tibet

目的:在"人人享有医保"的政策前提下,探讨西藏城乡居民基本医疗保险制度并轨的方案、面临的问题及对策。方法:采用描述与对比法,分析西藏城乡医疗制度运行的状况。结果:提出并轨面临户籍制度的限制、西藏城乡医疗卫生事业发展不均衡、并轨后管理方式等问题。结论:从横向统筹、由多部门协同管理、建立统一的医保信息管理系统、分级诊疗机制、完善藏药报销药品目录、"一制多档"、纵向统筹等方面提出政策建议,逐步实现西藏城乡医保制度的并轨。

Objective： Under the premise of the policy of ＂everybody has medical insurance＂, it discussed the integration plan of the basic medical insurance system for urban and rural ＂residents in Tibet about the problems and the countermeasures. Methods： De- scriptive and contrastive methods were used to analyze the status of urban and rural medical system operation in Tibet. Results： The problem of unbalanced development of urban and rural medical and health services in Tibet and the management of post-merger were put forward. Conclusion： It was necessary to put forward poliey recommendations from the aspects of horizontal co-ordination, muhi-seetoral collaborative management, unified medical insuranee information management system, hierarchical diagnosis and treat- ment mechanism, perfect Tibetan medMne reimbursement catalog, ＂one system and multiple files＂ and vertical co-ordination, and gradually realize the urban and rural medical insurance in Tibet System integration.