美国以医疗保险为主导的卫生保健体系介绍

Introduction of healthcare system centered on medicare in the United States

目的:以美国药师提供者地位的缺失为重点,介绍美国以医疗保险为主导的卫生保健体系,进一步为我国卫生保健体系改革和完善提供合理的建议。方法:采用文献研究法,整理近年来国内外相关文献、法案及官方政策,介绍美国以医疗保险为主导的卫生保健体系的现状,分析医疗领域社会工作的重要性,重点总结药师提供者地位缺失的原因和申请提供者地位的重要性,及其申请的历程和展望,结合我国实情,为我国医改提供参考意见。结果和结论:美国以医疗保险为主导的卫生保健体系发展完备,社会工作发展迅速,但是药师提供者地位的缺失严重阻碍药师服务的可及性和在综合医疗模式中的主动作用,因而美国药师正努力寻求相关法案的建立和实施。启示我国应积极推动医疗领域社会工作的开展、促进药师的职业作用、建立起相关完善的法律体制,从而推进我国卫生保健系统的发展和成熟。

Objective: To introduce the American healthcare system centered on medicare, focusing on the absence of provider status of American pharmacists, thusd to provide reasonable suggestions for the innovation and improvement of the healthcare system in China.Methods: Based on related domestic and foreign literatures, acts and official policies in recent years, literature research was conducted to introduce the present situation of American healthcare system centered on medicare, analyze the importance of social work in the medical field, elucidate the reasons and significance for that American pharmacists are not healthcare providers, as well as summarize the development process and prospect of related legislation. Combined with the reality in China, suggestions were put forward to innovate the healthcare system in China. Results & Conclusion: America has a well-established healthcare system and its social work develops rapidly. However, pharmacists are not medicare providers and cannot bill for provided services, which seriously affects the accessibility of pharmacists and their effective role in the team-based care. And American pharmacists are seeking the establishment and implementation of related bills positively. It inspires us that the development of social work in medical filed, the promotion of pharmacists' professional role, and a perfect and definite legal system are very important for China to facilitate the development and maturity of healthcare system.