我国基本医疗保险支付方式现状与对策研究

Research on Current Situation and Countermeasures of Basic Medical Insurance Payment Methods in China

通过分析我国现有的医疗保险支付方式及其效用,明晰其支付标准不合理、转诊制度不明显、支付方式缺乏监督、精细化管理不足等问题,从而有针对性地提炼出优化医疗保险支付的建议和对策,控制医疗费用不合理增长、缓解人民群众看病就医困难等问题,以提高医疗保险基金的使用率,进而提升医疗服务质量。

To clarify the problems withthe reasonable of payment standard,the obviousness of referral system,the supervision system of payment method,and the sufficient of fine management,by analyzing the current payment methods and its effectiveness of medical insurance in China.Then,the recommendations and countermeasures for optimizing medical insurance payment were extracted in a targeted manner to control the unreasonable growth of medical expenses,alleviate the difficulties of the people in medical treatment,improve the utilization rate of medical insu-rance funds and improve the quality of medical services.