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医保改革对医疗机构的影响

Voice from health services providers for impacts of health insurance reform

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【作者】 杨佳平严非王光荣李哲王伟刘晓云

【Author】 YANG Jia-ping, YAN Fei, WANG Guang-rong, LI Zhe, WANG Wei, LIU Xiao-yun (School of Public Health, Fudan University, Shanghai 200032, China; Zhabei Health Bureau, Shanghai 200070, China)

【机构】 复旦大学公共卫生学院上海市闸北区卫生局复旦大学公共卫生学院 上海 200032上海 200032上海 200070上海 200032

【摘要】 目的:从医疗服务供方的角度了解医保改革对医疗机构产生的作用和影响,为完善有关改革措施提供参考依据。方法:收集有关文献并采用定性调查的方法选取不同级别、不同类型医疗机构的管理和医务人员进行专题小组访谈和个别访谈。结果:医保改革促进了卫生服务的发展,也加剧了医疗机构之间的竞争;医保额度和有关指标的限定使医院的业务收入增幅有所下降,并促发了新矛盾的出现。结论:医保改革取得了一定成效,但医院在改革中呈现出压力过大、动力不足的状态,要发挥社会各方的作用,共同推进改革的顺利进行。

【Abstract】 Objectives:To better understand the views on health insurance reform and its impacts on hospitals operation form health staff perspective, and to provide evidence for comprehensive assessment combining other stakeholders. Methods: Focus group discussion and key informant interviews were applied in different sectors. Results:It demonstrated that the reform has accelerated the development of health services, and intensified the competitions among hospitals. But some rules influenced revenue increase of the hospitals, and some new conflicts revealed; new classification and application of medicine impacted on the community health service centers from two aspects. Conclusions:Health services providers recognized the achievement of the reform, but there were also some problems in practice, such as controlling medical fee increasing, much pressure and little motivation on hospitals.

【关键词】 医保改革医院影响
【Key words】 Health insurance reformHospitalsImpacts
【基金】 本项目为卫生部第三次全国卫生服务总调查卫生改革专题调查之一。
  • 【文献出处】 中国卫生资源 ,Chinese Health Resources , 编辑部邮箱 ,2005年04期
  • 【分类号】R197.3
  • 【被引频次】13
  • 【下载频次】325
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