基本医疗保险基金和公共卫生服务资金协同视角下的疾病早期筛查机制优化研究

Study on key issues of early diseases screening from the perspective of basic medical insurance and public health services coordination

在健康中国背景下,实现疾病早诊早治是健康管理的新目标、新要求。本文通过对我国疾病早期筛查服务存在的病种覆盖面小、人群覆盖率低等关键问题进行剖析,发现我国病种筛选方案还不完善,资金支付仍缺乏衔接,建议可从病种筛选标准和筛选流程两方面来优化病种筛选方案,同时基本医疗保险基金和公共卫生服务资金可采取“二次分类法”对不同类别的疾病实施不同的支付策略,加强支付衔接,为疾病早期筛查服务提供资金支持。

In the context of the Healthy China Initiative,early diagnosis and early treatment of diseases are new goals and requirements for health management.This article analyzes the key issues of early disease screening in China,such as small disease coverage and low population coverage and finds that the disease selection method of China’s disease screening projects is not yet perfect,and there is still a lack of connection in fund payment.Accordingly,it is suggested that the disease screening scheme can be optimized from the aspects of disease screening criteria and screening process and meanwhile,the basic medical insurance fund and public health service fund can adopt the“secondary classification method”to implement different payment strategies for different types of diseases,strengthen the payment connection and provide financial support for early disease screening.