The Path of Integrated Use of Health Insurance Fund and Public Health Fund Under the Perspective of Healthy China

Corresponding author: dingjinxi, 13605152326@163.com

DOI: 10.12201/bmr.202411.00009

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  Abstract: The integrated use of health insurance funds and public health funds is the driving force for promoting service integration and continuously advancing the construction of a Healthy China. Based on the synergistic advantage theory and the PCIC theory, this paper proposes three paths to promote the integrated use: rationalizing the functional position and service supply of the two parties, optimizing the payment and incentive mechanism , and strengthening the capacity building of service buyers. Based on the above path perspective, this paper finds that the current domestic exploration and practice of coordinated use has achieved certain results, but there are also problems such as unclear funding sources, unclear scope of purchased services, insufficient coordination of multi-subject assessment incentives, weak correlation with health outputs, insufficient cost accounting and health measurement assessment capabilities, and imperfect information system interconnection. It is recommended to improve the top-level design, establish an assessment and payment incentive mechanism related to health outcomes, and realize the dynamic construction of fund expansion and informatization.

  Key words: Health insurance funds; Public health funds; Coordinated use; Synergistic advantage

  Submit time: 7 November 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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