论文部分内容阅读
目的:探讨适合中医药特点的医保支付方式,为完善中医药医保支付制度提供依据。方法:采取实地调研与文献研究相结合的方法,分析目前医疗机构所采取的按项目付费、按病种付费及总额预付方式对中医服务的利用及中医药事业发展的影响。结果:我国目前的医保支付方式并不符合中医药的特点,其在一定程度上制约了中医药特色及优势的发挥。结论:基于“循证+价值”的观点,提出总额预付和按病种付费结合的符合中医药发展规律的中医药医保制度。
Objective: To explore the medical insurance payment method suitable for the characteristics of traditional Chinese medicine and provide the basis for improving the medical insurance payment system of traditional Chinese medicine. Methods: A combination of field research and literature research was adopted to analyze the impact of the current medical institutions adopting project-based payment, disease-based payment and total prepayment on the utilization of TCM services and the development of Chinese medicine. Results: The current medical insurance payment in our country does not accord with the characteristics of traditional Chinese medicine, which to a certain extent restricted the development of TCM characteristics and advantages. Conclusion: Based on the viewpoints of “evidence-based value and value-based”, this paper proposes a medical insurance system in accordance with the development of traditional Chinese medicine that combines total prepayment and disease-based payment.