保险学-医保支付制度改革与分级诊疗制度的协同发展研究VIP专享

医保支付制度改革与分级诊疗制度的协同发展研究【摘要】近几年来，我国多地都试图通过扩大不同层级医院的报销比例，利用价格手段来吸引居民基层就诊，但政策效果并不显著 [1]。本文的目的是从支付制度和分级诊疗制度的相互影响作用方面来做二者对医保的实际影响的分析，以及得出如何利用二者的协同性来改善我国的医疗卫生服务状况的一些建议。本文将通过对比国内外支付制度和分级诊疗制度的对比以及分析支付制度与分级诊疗制是如何相互影响各自的实施效果及对医保最终效果的影响，从而说明发挥二者协同作用来实现优化我国医疗资源分配、调高卫生服务质量等目标的重要意义等。最后从利用医疗保险支付制度与医保分级诊疗制度的协同发展作用的角度，为推进我国的医保制度改革创新的顺利进行提供建设性的，可应用的建议。【关键词】医保支付制度；分级诊疗制度；协同发展；注：本论文（设计）题目来源于教师的国家级（或省部级、厅级、市级、校级、企业）科研项目，项目编号为： B2019233 。 A Comparative Study on the Impact of DRGs and Disease-Based Score Payment to the Core Stakeholders’ Behavior[Abstract] In recent years, many places in our country have tried to attract people to see doctors at the grass-roots level by expanding the reimbursement proportion of hospitals at different levels and using price means, but it didn’t work very well. The purpose of this article is to analyze the actual effect of the interact effect between the payment system and hierarchical medical system to the final effect to medical insurance, and get some suggestion about how to use the synergy of them to improve the institution of Medical and Health here. This paper will compare the Medical insurance payment system and the Classification diagnosis and treatment system at home and abroad, and analyze how the payment system and the hierarchical diagnosis and treatment system affect each other, so as to illustrate the important significance of playing the synergy between the two to achieve the goa...