通讯作者: 许光建, xgj@ruc.edu.cn

DOI：10.12201/bmr.202104.00018

Research on the linkage mechanism between the adjustment of medical service price and the reform of medical insurance payment mode in China

• 摘要：相较于医药医保、医药医疗间关系的渐趋合理,医保与医疗间协调互动关系仍亟待深入讨论。医疗服务价格动态调整和医保支付方式优化分别是针对供给方和购买方的重要改革思路,两方面改革均有助于提升医疗体系改革成效,本文基于发挥政策合力提升社会福利水平的研究目标分析了如何建立二者的联动机制。研究结论主要是,应遵循激励相容的改革原则,以改善医疗机构行为作为联动机制的关键政策节点,通过构建互动嵌套的优化机制发挥政策合力。此外,联动机制的良好运转也需外部协同治理,本文建议应推行健康管理促进居民生活方式科学化、推进医联体建设提高优质医疗资源共享水平以及推动互联网与医疗服务的进一步产业融合化。

  关键词： 医疗服务价格改革; 医保支付方式改革; 医疗体系改革

   

  Abstract: The relationship between medicine and medical insurance is increasingly reasonable, and the same between medicine and medical treatment, however the relationship between the medical insurance and medical treatment needs further discussion. The dynamic adjustment mechanism of medical service price is the key point of medical treatment reform, and the better choice of insurance payment mode is the linchpin of medical insurance reform. This paper is focused on analyzing the internal logic relationship between the two, and exploring the practical path of the reform linkage mechanism under this logical framework. The conclusion of this study points out that the linkage mechanism between the dynamic adjustment of medical service price and the reform of medical insurance payment mode should be constructed following the reform principle of incentive compatibility. During this process, improving the behavior of medical institutions is the key policy node of linkage mechanism, and policy synergy should be given full play by building an optimized, interacted and nested mechanism. In addition, the good operation of the linkage mechanism also needs external collaborative governance. This paper suggests that we should promote health management to promote the healthy lifestyle of residents, promote the construction of integrated health care system to improve the sharing level of high quality medical resources, and promote the further industrial integration of the Internet and medical services.

  Key words: Medical service price reform; Medical insurance payment reform; Medical system reform

  提交时间：2021-06-22

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2021-04-15	bmr.202104.00018V1	下载

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