中国医疗保障决策体制的演进历程、经验总结与完善建议

Development Analysis and Prospect of Chinese Medical Security Decision System

医疗保障决策体制是医疗保障管理体制的组成部分。合理、科学地界定基本制度、基本政策和项目标准,是医保制度走向成熟、稳定和高效的重要表现。通过梳理中国医疗保障决策体制的历史沿革和现状分析发现,我国医疗保障决策体制存在法制化程度不高、部门决策重心偏低、职能关系尚未理顺等问题。应尽快出台相关政策加快医保法制化进程、合理划分各级政府医疗保障决策权限、强化医疗保障跨部门综合决策、完善医疗保障决策的支撑体系、合理把握医保决策集中与分散的调整节奏等,促进医疗保障决策体制转变与完善。

The medical security management system is the key component of the decision system.A reasonable and scientific definition of the essential factor,including basic policies and standardized procedure,is an important manifestation of the completeness,stability and efficiency of the medical security system.Therefore,we have constructed the image of historical development and the present situation of Chinese health care decision system analysis.By presenting difficulties including the lower level of legalization,department decision-making low center of gravity,the policy suggestions are put forward to promote the transformation and improvement of medical security decision-making system on that basis.