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在推进医疗保险制度改革过程中,医疗费用结算方式是改革的重要内容之一。认真研究医疗费用的多种支付方式,剖析利弊,选择适合当地实际的支付方式十分重要;甚至有人把医疗保险机构与医疗机构的结算方式形象地称为控制医疗费用支出的阀门。 国际实践,常见的基本结算方式有:按服务项目支付;按人头支付;预算支付和按病种支付。 按服务项目支付(结算)方式是一种最古老的卫生服务支付方式,我国实行了几十年的公费医疗、劳保医疗,基本上都是采用这种结算方式,即单位按照医疗机构提供服
In promoting the reform of the medical insurance system, the settlement of medical expenses is one of the important contents of the reform. It is very important to carefully study the various payment methods of medical expenses, analyze the advantages and disadvantages, and choose the appropriate payment method for the actual local area. Some even consider the settlement method of medical insurance institutions and medical institutions as the valve to control medical expenses. International practice, common basic settlement methods are: pay by service; pay by head; budget payment and pay by disease. Payments by service items (settlement) is one of the oldest payment methods of health services, our practice of several decades of public health care, medical insurance, are basically using this settlement, the unit in accordance with the medical institutions to provide services