【作者】 刘敏；

【导师】 邱成梅； 高文化；

【作者基本信息】 湖南农业大学 ， 公共管理硕士（MPA）（专业学位）， 2020， 硕士

【摘要】 党的十七大会议决定将政府的服务型建设作为政府职能改变的目标,对政府官员要求必须有“社会本位、权力本位、民本位”的观念思想,国家的主人就是人民,政府官员必须要一心一意为人民服务,实现公共利益最大化。现阶段,随着社会经济不断快速发展,人口流动已非常的常态化,越来越多的异地就医诉求以及越来越严重的异地就医矛盾逐渐凸显。在当今建设服务型政府过程中,怎样让医保部门办事服务能力得以提升,将医院异地就医服务能力得以提升,让异地就医结算服务效率得以提升,实现高效有序的异地就医联网结算成为亟待解决的突出问题。本文首先从异地就医联网结算的基本情况入手,对其社会背景、管理模式、运行现状进行分析,总结出了在异地就医联网结算中出现的问题主要集中于结算系统、报销待遇、医院方面、基金监管、政策宣传、医疗机构数量等领域,并针对这些问题提出了几个有效的对策:完善结算信息平台,提高及时结算效率;完善报销政策,缩小地区间统筹差异;医院应对跨省异地就医联网结算需实施的措施;加大异地就医联网结算政策宣传力度;转变政府职能,加强顶层设计等途径。通过本文研究以期对完善异地就医联网结算制度、推进医保制度改革有所助益。更多还原

【Abstract】 The 17 th National Congress of the Communist Party of China takes the construction The transformation of government functions with the goal of service-oriented government,and requires all levels of governments and officials to establish the idea of "people-oriented,social oriented and rights oriented",that is,the people are the masters of the country,and the government must serve the people wholeheartedly to maximize the public interest.At this stage,with the continuous development of economy and society and the gradual normalization of population flow,more and more frequent demands for medical treatment in different places and more and more serious conflicts of medical treatment in different places are brought about.In the process of building a service-oriented government,how to improve the handling service capacity of medical insurance agencies,improve the settlement service capacity of hospitals in different places,improve the settlement efficiency of different places,and achieve efficient and orderly online settlement of different places has become an urgent problem to be solved.This paper starts with the basic situation of remote medical online settlement,analyzes its social background,management mode and operation status,summarizes that the problems in remote medical online settlement mainly focus on settlement system,reimbursement treatment,hospital,fund supervision,policy publicity,number of medical institutions and other fields,and puts forward several effective solutions to these problems Countermeasures:improve the settlement information platform,improve the efficiency of timely settlement;improve the reimbursement policy,reduce the overall differences between regions;the measures that the hospital should implement in response to cross provincial and cross regional medical network settlement;increase the propaganda of cross regional medical network settlement policy;change the government functions,strengthen the top-level design and other ways.This paper aims to improve the settlement system of remote medical network and promote the reform of medical insurance system.更多还原