我国高值医用耗材医保目录管理研究
Research on the Management of High-Value Medical Consumables Medical Insurance Catalogue in China
王锐 1李佳明 1孟凡月 1李伟 1丁锦希1
作者信息
摘要
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.
Abstract
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.
关键词
高值医用耗材/医保目录/结构优化Key words
high-value medical consumable/medical insurance catalogue/structure optimization引用本文复制引用
出版年
2024
NETL
NSTL
万方数据