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目前,全国已有半数以上市县实施了工伤保险改革,初步形成了以工伤保险费用社会统筹为主要内容,工伤补偿、工伤预防和工伤康复相结合的工伤保险体系,较好地落实了工伤职工及其亲属的工伤待遇,维护了他们的合法权益。但是,还存在着许多问题,其中较为突出的是工伤医疗费用支出偏高,工伤保险待遇支出偏低。据初步统计,长期以来,许多地方的工伤医疗费用支出占工伤保险待遇总支出的一半以上,有的甚至超过60％。因此,必须加强对工伤医疗的管理。在保证治疗、节约开支、克服浪费的原则下,建立起对医患双方都有效的医疗费用控制机制,保障工伤职工得到及时、合理、优质的医疗服务,控制工伤医疗费用的不合理增长,保证工伤保险基金安全、合理地使用,这是工伤保险经办机构丞待解决的新问题。
At present, over half of the cities and counties in the country have implemented the reform of industrial injury insurance, and initially formed an industrial injury insurance system that takes social pooling of industrial injury insurance costs as the main content, industrial injury compensation, industrial injury prevention and industrial injury rehabilitation, And their relatives work injury treatment, safeguarding their legitimate rights and interests. However, there are still many problems, of which the more prominent ones are the high expenditure on medical expenses for work-related injuries and the low expenditure on work-related injury insurance. According to preliminary statistics, over a long period of time, medical expenses in many places have accounted for more than half of the total expenditure on work-related injury insurance, and some even exceed 60%. Therefore, we must strengthen the management of occupational injury medical treatment. Under the principle of ensuring treatment, saving expenses and overcoming waste, we have established a medical expense control mechanism that is effective for both doctors and patients to ensure that injured workers receive timely, reasonable and quality medical services and control unhealthy growth of medical expenses for occupational injuries, Industrial injury insurance fund is safe and reasonable to use, which is a new issue to be solved by the work-related injury insurance agencies.