發(fā)布時間：2018-08-23 09:39

【摘要】：目的:明確醫(yī)保制度運行的突出問題,分析問題背后深層次的根源,為政策制定者提供決策的依據(jù)。方法:運用文獻研究、現(xiàn)場調(diào)查和專家小組的方法進行問卷的調(diào)查,并采用TOPSIS綜合評價法對我國醫(yī)保制度運行的問題進行綜合評價。結(jié)果:我國醫(yī)保制度運行的6大突出問題排序為基金籌集相關(guān)問題(C_i=0.722)、基金運行和管理(C_i=0.634)、經(jīng)濟保護能力(C_i=0.471)、監(jiān)督運行機制(C_i=0.388)、衛(wèi)生服務(wù)利用公平性(C_i=0.374)和管理制度問題(C_i=0.347)。結(jié)論:大力推進城鄉(xiāng)居民的醫(yī)保制度籌資機制,實現(xiàn)從定額籌資到按可支配收入為基數(shù)籌資的過渡,通過控制醫(yī)療費用不合理的增長來保障基金的收支平衡,提高醫(yī)保的統(tǒng)籌層次以及大病醫(yī)保政策的有效推動等一攬子方案是醫(yī)保制度運行問題的根本解決措施。
[Abstract]:Objective: to clarify the prominent problems in the operation of medical insurance system, analyze the underlying causes of the problems, and provide the basis for policy-makers to make decisions. Methods: the methods of literature research, field investigation and expert group were used to investigate the questionnaire, and the comprehensive evaluation method of TOPSIS was used to evaluate the operation of medical insurance system in China. Results: the six prominent problems in the operation of medical insurance system in China were fund raising related problems (C_i=0.722), fund operation and management (C_i=0.634), economic protection ability (C_i=0.471), supervision mechanism (C_i=0.388), health service utilization equity (C_i=0.374) and management system problem (C_i=0.347). Conclusion: promote the financing mechanism of urban and rural residents' medical insurance system, realize the transition from quota financing to disposable income financing, and ensure the balance of income and expenditure of the fund by controlling the unreasonable growth of medical expenses. Improving the overall level of medical insurance and the effective promotion of medical insurance policy are the fundamental measures to solve the operational problems of medical insurance system.
【作者單位】： 哈爾濱醫(yī)科大學(xué)衛(wèi)生管理學(xué)院;寧波大學(xué)醫(yī)學(xué)院預(yù)防醫(yī)學(xué)教研室;
【基金】：國家自然科學(xué)基金項目(71333003,71573068) 教育部人文社科基金項目(14YJC630046)
【分類號】：F842.684;R197.1

【參考文獻】

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