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控制医疗费用的快速增长,降低医疗成本,提高基金使用效率,这是医疗保险运行过程中的重要问题。国家在公立医院改革中,明确提出了完善基本医疗保障费用支付模式,鼓励探索实行按病种付费、按人头付费、总额预付等结算方式。山东省烟台市实施按人头付费、总额控制结算模式已超过10年,实践证明,科学实行按人头付费结算办法,扬其长避其短,既能满足患者的医疗需求,又能有效控制医疗费用的增长。
Control the rapid growth of medical costs, reduce medical costs and improve fund efficiency, which is an important issue in the operation of medical insurance. In the reform of public hospitals, the state made it clear that the payment mode of basic medical insurance should be perfected, and encouragement should be made to explore ways to pay according to disease types, payment on a per capita basis and prepaid amounts of total amount. Shandong Province, Yantai City, according to the implementation of payment by head, the total control settlement mode for more than 10 years, practice has proved that the implementation of science-based pay-per-settlement approach, Yang avoid its short, both to meet the patient’s medical needs, but also effective control of medical costs growth of.