医保支付制度改革对全科医生正向激励机制研究综述

目的:理清医疗保险支付策略与我国新时期卫生与健康工作方针之间的联动作用机制,进一步促进"三医"联动.方法:文献分析法梳理混合支付制、总额预付制、价值付费制的优势和局限.结果:我国加快建立紧密型医疗联合体的政策环境下,应以混合支付策略为指导,实施以人头总额预付为框架,价值付费为重要补充的支付方式,实现医保支付对全科医生的正向激励.结论:新医保付费方式的多元组合适应时代潮流,但实现多方激励相容仍需在文化、行政、市场、谈判机制等方面做出改进.

Research and Review on Positive Incentive Mechanism of Medical Insurance Payment System Reform to General Practitioners

Objective:To clarify the linkage mechanism between the payment strategy of medical insurance and the health policy in the new period of China,and further promute the "three medical linkage".Methods:Literature analysis was used to analyze the advantages and limits of the mixed payment system,total prepayment system and value payment system.Results:Under the policy environment of speeding up the establishment of close medical association in China,it needed to take the mixed payment strategy as the guidance,implement the payment strategy with total head prepayment as the framework and value payment as an important supplement,so as to realize the positive incentive of medical insurance payment to general practitioners.Conclusion:The multiple combination of the new medical insurance payment mode adapted to the trend of the times,but the multi incentive compatibility still needed to be improved in the aspects of culture,administration,market and negotiation mechanism.