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上海市商业健康保险制度研究

A study on Shanghai commercial health insurance policy

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【作者】 顾静文董蘅苏家春卢燕雯胡敏陈宏

【Author】 GU Jing-wen,DONG Heng,SU Jia-chun,LU Yan-wen,HU Min,CHEN Hong(Huashan Worldwide Medical Center,Huashan Hospital,Fudan University,Shanghai 200040,China)

【机构】 复旦大学附属华山医院国际医疗中心

【摘要】 通过对国际医疗保健模式的比较和国内社会医疗保险及商业健康保险的分析,并结合高端医疗服务的现状,提出建立适应上海高端人群医疗服务特点的上海商业健康保险新模式。基本医疗服务由社会保险给予支付,高端医疗服务通过分类给付办法,即在社会医疗保险支付基本医疗服务费用基础上,其余费用由商业健康保险给予支付。基本医疗保险与商业健康保险相结合,满足不同层次人群对医疗服务的需求。

【Abstract】 Through the analysis of international healthcare models and domestic social healthcare system as well as commercial health insurance,combined with the status of premium health services,the establishment of a new model of the Shanghai commercial health insurance was proposed: health services include basic and premium health services.The basic health service was covered by basic health insurance undertaken by the government and premium health service beyond basic health insurance was covered by commercial health insurance companies.The combination of basic and commercial health insurance can be used to meet different levels of demand for health services.

【基金】 2010年上海市卫生局卫生政策研究课题上海市商业健康保险制度研究基金资助项目,项目编号:2010HP014
  • 【文献出处】 中国卫生资源 ,Chinese Health Resources , 编辑部邮箱 ,2012年05期
  • 【分类号】F842.6
  • 【被引频次】7
  • 【下载频次】195
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