论文部分内容阅读
目的探索医保政策在社区卫生服务筹资方面的作用及潜力。方法采用描述性统计分析的方法对医保在社区卫生服务利用和业务收入方面的作用及情况进行描述和比较。结果 3年间社区卫生服务利用者医疗费用支付方式的构成有显著性差异;参保居民优先选择医保定点机构的比例高于非参保居民;医保定点后社区卫生服务机构收入有所增长;启动医保补偿机构的医保收入占业务收入的比例总体呈上升趋势,但仍较低。结论参保居民就诊比例逐年上升;医保定点是影响参保居民选择就诊机构的重要因素;医保政策筹资效用显现,但仍有较大潜力。
Objective To explore the role and potential of health insurance policies in financing community health services. Methods Descriptive statistics were used to describe and compare the roles and situations of health insurance in community health service utilization and business income. Results The proportions of medical expenses paid by community health service users in three years were significantly different. The proportion of insured residents giving priority to medical insurance fixed-point institutions was higher than that of non-insured residents. The income of community health service institutions increased after medical insurance set-point. Reimbursement agencies’ health insurance revenue as a percentage of operating income generally shows an upward trend but remains low. Conclusion The proportion of insured residents insured increases year by year. Medicare fixed-point is an important factor affecting the insured residents’ choice of medical institutions. However, there is still great potential for fund-raising effect of medical insurance policies.