澳大利亚门诊医疗保险制度及借鉴
The Outpatient Medical Insurance System in Australia and Its Enlightenment
冯毅1
作者信息
- 1. 遵义医科大学卫生政策与管理研究中心 贵州 遵义 563000
- 折叠
摘要
澳大利亚健康保险制度中注重公平性和高效性的特征,使其成为了世界健康保险制度中的一种重要模式.文章介绍澳大利亚门诊医疗保险制度,以期为国内正在开展的门诊统筹实践提供一定的参考借鉴.其管理经验带来的启示包括逐步推行门诊医药分开管理,分别设计医保政策;因地制宜地推行门诊全科医生首诊制;门诊统筹的封顶线不宜设计过低,并对弱势群体实施一定的倾斜.
Abstract
The emphasis on equity and efficiency in the Australian health insurance system has made it an important model in the world.The outpatient medical insurance system in Australia is introduces to provide some references for the ongoing outpatient pooling fund practice in China.Insights from its management experience include the gradual implementation of separate management of outpatient medicine and the design of separate health insurance policies;the implementation of the first consultation system for out-patient general practitioners according to local conditions;the top line for outpatient pooling fund should not be designed too low and should be inclined towards vulnerable groups.
关键词
门诊医疗保险/政策/澳大利亚Key words
outpatient medical insurance/policy/Australia引用本文复制引用
基金项目
贵州省哲学社会科学规划项目(22GZYB69)
出版年
2024
NETL
NSTL
万方数据