山东省基本医疗保险门诊慢性病管理政策梳理及评价

Review and Evaluation of Outpatient Chronic Disease Management Policy of Basic Medical Insurance in Shandong Province

从门诊慢性病的病种数量、保障范围、保障水平、定点管理制度、结算方式等方面对山东省16个地市基本医疗保险门诊慢性病管理政策进行梳理,分析其中存在的问题,并提出政策建议:合理确定门诊慢性病的病种范围、准入标准和待遇水平,加强门诊慢性病的精细化管理,制定专门的门诊慢性病保障范围和供方支付方式。

From the aspects of the number of outpatient chronic diseases,security scope,security level,fixed-point management system,settlement method,etc.,this paper reviews the outpatient chronic disease management policy of basic medical insurance in 16 cities of Shandong Province,analyzes the existing problems,and puts forward policy suggestions:reasonably determine the scope of disease types,access standards,and treatment levels of outpatient chronic diseases,strengthen the refined management of outpatient chronic diseases,and formulate special security scope and supplier payment methods of outpatient chronic diseases.