首页|我国高值医用耗材医保目录管理研究

我国高值医用耗材医保目录管理研究

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高值医用耗材治疗费用高、患者负担重,我国尚未建立全国统一的医保耗材目录,医用耗材医保支付管理属于区域性政策,存在管理碎片化、保障效果不足、公平性差异大等问题.本文从我国医用耗材目录管理现状出发,围绕诊疗引导、价格杠杆、支付管理三方面对目录功能进行深入剖析,并基于域内外成熟管理经验,优化目录结构,为完善我国省级高值医用耗材医保目录提供参考.
Research on the Management of High-Value Medical Consumables Medical Insurance Catalogue in China
High-value medical consumables mean high treatment costs and heavy burdens on patients.China has not developed a unified medical insurance catalogue of medical consumables at the national level.The management of medical insurance payment for medical consumables is a regional policy.There are problems such as fragmented management,insufficient reimbursement,and significant difference in fairness.This paper starts from the current status of medical consumables catalogue management in China,conducts an in-depth analysis of the catalogue's functions around diagnosis and treatment guidance,price leverage,and payment management,and optimizes the structure based on the domestic and foreign management experience to provide a reference for improving the provincial high-value medical consumable medical insurance catalogue in China.

high-value medical consumablemedical insurance cataloguestructure optimization

王锐、李佳明、孟凡月、李伟、丁锦希

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中国药科大学 南京 211198

高值医用耗材 医保目录 结构优化

国家医疗保障局项目

2024

中国医疗保险
中国医疗保险研究会

中国医疗保险

影响因子:0.492
ISSN:1674-3830
年,卷(期):2024.(5)
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