通讯作者: 邵蓉, shaorong118@163.com

DOI：10.12201/bmr.202404.00028

Analysis of the impact of incorporating pharmacies into outpatient insurance pooling fund management policies on relevant stakeholders

• 摘要：目的:为定点零售药店纳入门诊统筹管理政策完善提供思路和依据。方法:基于利益相关者理论,结合文献综述、访谈调研定性分析定点零售药店纳入门诊统筹管理政策的实施对相关利益者的影响。结果和结论:理想层面上,定点零售药店纳入门诊统筹管理政策的顺利实施能够缓解职工医保个人账户改革所带来的冲击,优化我国医疗卫生体制,明确零售药店定位,促进医药分开,缓解医疗机构就诊压力,提升参保人购药的便利性。然而,受制于政策设计不完善、配套措施未及时跟进等因素,短期内政策产生的实际影响与理想存在差异。为助力政策完善,建议医保部门持续收集政策实施的反馈,不断优化政策设计；完善政策时以参保人为核心,兼顾多方主体利益；充分了解相关主体的特点和利益关系,强化医保基金监管。

  关键词： 药店; 门诊; 统筹; 政策; 影响; 相关利益者

   

  Abstract: Objective: To provide ideas and basis for the improvement of incorporating pharmacies into outpatient insurance pooling fund management policies. Method: Based on stakeholder theory, combined with literature review and interview research, qualitative analysis was conducted on the impact of the implementation of incorporating pharmacies into outpatient insurance pooling fund management policies on relevant stakeholders. Results and Conclusion: From an ideal perspective, the successfully implementation of the policy of incorporating pharmacies into outpatient insurance pooling fund management can alleviate the impact of individual account reform in employee medical insurance, optimize Chinas medical and health system, clarify the positioning of pharmacies, promote the separation of medical institutions and pharmacies, alleviate the pressure of medical institutions, and improve the convenience of insured individuals in purchasing medicine. However, due to factors such as incomplete policy design and untimely follow-up of supporting measures, the actual impact of policies in the short term differs from ideal. To assist in policy improvement, it is recommended that the medical insurance department continue to collect feedback on policy implementation and continuously optimize policies; Improve policies with insured individuals at the core, taking into account the interests of multiple stakeholders; Fully understand the characteristics and interests of relevant parties, and strengthen the supervision of medical insurance funds.

  Key words: Pharmacy; Outpatient; Pooling fund; Policy; Impact; Stakeholders

  提交时间：2024-04-16

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• 序号	提交日期	编号	操作
  1	2024-01-05	bmr.202404.00028V1	下载

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