试论医疗保险和社区卫生服务的相互关系

医疗保障制度的改革与区域卫生规划的实施是当前卫生改革面临的两项重要内容。实施医疗保险制度的最终目标是保障职工的基本医疗需求,而社区卫生服务针对人民群众的健康需求,形成以社区为基础,以家庭为单位,以居民为对象,以服务为核心,集医疗、预防、保健、康复、健康教育为一体的全科医疗服务模式,是基本医疗保障的一种形式,两者相互依存,互为补充,本文通过论述医疗保险和社区卫生服务的关系,为探索具有城市特色的医疗保险模式提供参考。１医疗保险与社区卫生服务的现况１．１稳步推进医疗保险制度改革 随着上海社会保障体系的…     

完善医疗保障制度实现全民医保

介绍了上海医疗保障体系的概况和实施成效,分析存在的问题和面临的挑战,提出完善医疗保障体系的总体目标和重点任务.上海已初步形成"三纵三横"的医疗保障制度体系,为减轻参保人员医疗费用负担、推动经济社会发展起到了积极作用,已基本实现国家医改意见中提出的基本医疗保障制度建设近期目标.为进一步贯彻落实国家医改要求,上海将通过整合各类制度、缩小待遇差距、完善医保管理、建立老年护理保障制度等举措进一步完善医疗保障体系,力争2012年户籍人口医疗保障制度覆盖率达到98%,常住人口覆盖率达到90%.

Abstract：

The paper introduces an overview of Shanghai medical security system, analyzes its effectiveness and challenges, and put forward overall goals and key tasks in the future. Shanghai has formed a multiple, medical security system and basically achieved the short-term goal of medical security system establishment which was requested to put forward in national health system reform. Shanghai medical insurance system has played a positive role in promoting economic and social development and reducing the burden of medical expenses. To further implement requirements of national health system reform, Shanghai will be conducting the integration of different schemes , narrow down the gap of benefit packages, improvement of health care management and the initiatives of nursing care insurance to further improve the medical security system, and strive to cover 98% of household population and 90% resident population in 2012.