健康共同体集团体制下多层次医疗保障体系的慢性病管理创新探索

Innovation Exploration of Chronic Disease Management in Multi-Level Medical Security System under the Health Community Group System

在慢性病负担持续加重的社会背景下,构建慢性病管理多层次医疗保障体系的重要性日益凸显。玉环市人民医院健康共同体集团针对多元的慢性病管理需求,与政府、高等院校、第三方机构等单位多方合作,在医保资金按疗效付费、基层财政补偿机制、商业保险等领域开展探索,尝试构建慢性病管理多层次医疗保障体系。文章介绍了当前慢性病管理的医保支持政策、基层运行现状及在此背景下的上述创新实践,为各地方在完善慢性病全程闭环管理的保障配套方面提供先行、先试经验。

Under the social background of the increasing burden of chronic diseases,the importance of constructing a multi-level medical security system for chronic disease management has become increasingly prominent.In view of the diversified chronic disease management needs,Yuhuan People's Hospital Health Community Group cooperates with government units,institutions of higher learn-ing,third-party institutions and other units to explore in the fields of payment of medical insurance funds according to curative effect,grass-roots financial compensation mechanism,commercial insurance,special needs services,and tries to build a multi-level medical security system for chronic disease management.It introduces the current medical insurance support policy of chronic disease manage-ment,the status quo of grass-roots operation problems and the innovative practice of Yuhuan,which provides the pilot experience for various localities in improving the support of the whole closed-loop management of chronic diseases.