我国部分城市门诊特殊疾病管理现状与策略研究

Research on the Current Situation and Strategy of Special Disease Management in Outpatient Clinics in China

门诊特殊疾病管理政策是我国基本医保的重要组成部分。当前,大部分城市都推出了门诊特殊疾病政策,减少患者的就医压力。梳理了我国部分主要城市在门诊重症特殊疾病认定、就医、医保结算、监督管理等方面的发展情况,对现状和问题进行分析,并且对鉴定标准、信息化管理、退出机制等方面提出了针对性建议,以期为门诊特殊疾病管理制度优化提供参考和建议。

The Outpatient special disease management policy is an important part of my country’s basic medical insurance.Currently,all cities have introduced special disease policies in Outpatient clinics to reduce the pressure on patients to seek medical treatment.The article combs the development status of major cities in China in the identification,medical treatment,medical insurance settlement,supervision and management of outpatients and special diseases,analyzes the status quo and problems,and proposes specific measures for identification standards,information management,and exit mechanisms,in order to provide references and suggestions for the optimization of Outpatient special disease management system.