摘要
Reimbursement policy for outpatient chronic diseases is an important part of the basic medical insurance scheme in China. The reimbursement policy for outpatient chronic diseases in basic medical insurance for urban residents of provincial capitals in China were analyzed from the perspectives of disease types, benefits package, qualification and health service access. Proposals to improve policy design, establish standardized disease inclusion criteria and set reasonable benefits package, strengthen management and complete supporting policy, strengthen policy coordination were put forward according the existing problems such as fragmented policy, great difference in disease types and benefit package, supervision difficulty, incomplete policy framework and lack of policy coordination.
门诊慢性病是我国基本医疗保险制度的重要内容。本文对我国省会城市城乡居民医保门诊慢性病政策从病种、待遇、准入和就医管理等方面进行分析,发现存在制度碎片化、病种设置差异大、待遇不公平、执行管理困难、政策衔接和配套措施不完善等问题,建议完善顶层设计,建立规范的病种遴选标准,合理设定筹资和待遇水平,加强执行管理,完善配套措施,加强制度衔接,坚持三医联动深化改革等。
