利益相关者理论视角下基本医疗保险异地就医结算服务研究

文章基于利益相关者理论分析异地就医结算服务中的主要利益相关者之间的功能定位,发现参保人员政策的知晓度、地区间分散化的管理模式以及医疗机构的管理难度等多重因素均成为异地就医政策的制约瓶颈。建议可从加强顶层设计,构建统一协调机制、全方位加强异地就医政策的宣传工作、完善信息沟通平台、提升异地结算效率等多方面改进,顺利推进异地就医结算工作。

Study on medical treatment settlement service in different places of basic medical insurance under the perspective of stakeholder theory

This paper analyzes functional positioning among main stakeholders in the settlement service of medical treatment in different places based on stakeholder theory. It finds that many factors such as the awareness of policy,decentralized management model and the difficulty of management of medical institutions have become the restrict bottleneck of the policy of medical treatment in different place. It is suggested that the improvement should from strengthening top-level design,building unified coordination mechanism,comprehensively strengthening the propaganda of the policy of seeking medical treatment in different places,improving information communication platform and the efficiency of settlement in different places,so as to promote the smooth progress of medical treatment settlement in different places.