中国异地就医结算服务改革进展及建议

Progress and Suggestions on the Reform of Long-Distance Reimbursement in China

异地就医即时结算系统已推广至全国范围内实施,定点医院基本医疗保险可跨省即时结报。目前国家异地就医结算系统仍存在一些不足:异地就医即时报销进展速度相对缓慢;低收入人群跨省异地就医较难实现,保险报销分布不均匀;异地就医信息平台系统不完善;异地就医监管难;医保基金存在一定风险。今后应逐步扩大异地就医覆盖医保类型和人群,建立常住外来人口差异化医保,强化异地就医监管,建立及时回款机制,同时积极推行分级诊疗。

Using descriptive analysis we went through up-to-now studies and policies related to long-distance medical reimbursement.The immediate reimbursement of medical treatment had been implemented nationwide among designated hospitals.At present,there were still some deficiencies.It was more difficult for low-income people to seek medical treatment in different provinces,and the distribution of insurance reimbursement was uneven.The system of long-distance medical treatment information platform was not perfect.It was difficult to seek medical supervision in different places.There were risks to the health care fund pool.In the future,we should gradually enlarge the coverage of long-distance medical health care,to establish permanent floating population health care,to strengthen the long-distance medical supervision,set up the mechanism of timely cash transfer,at the same time actively promote grading diagnosis and treatment.