| 公立医院改革的支点和模式 |
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| 引用本文： | 赵云.公立医院改革的支点和模式[J].中国医院,2013(11):36-39. |
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| 作者姓名： | 赵云 |
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| 作者单位： | 右江民族医学院公共卫生与管理学院，533000 广西百色市城乡路98号 |
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| 基金项目： | 教育部人文社会科学研究项目“公立医院体制机制与医疗保险付费方式的适配性研究”(13YJCZH271)；广西高等学校人文社会科学研究项目“广西县级公立医院长效补偿机制的创构基于医疗保险付费制度的研究”(SK13YB074)。 |
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| 摘 要： | 由于医疗保险付费方式本质上是一种医疗资源的配置机制，所以医疗保险付费方式可以撬动公立医院的体制机制变革。以医疗保险后付费方式为支点，可以建成公立医院的绩效型行政化体制；以医疗保险预付费方式为支点，可以建成公立医院的治理型市场化机制。从价值兼容、制度协同和目标一致三个角度，比较分析了公立医院的两类体制机制，主张公立医院的治理型市场化机制。
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| 关 键 词： | 公立医院改革 医疗保险 付费方式 |
Governance mechanism of medical quality risk under prepaid mode of medical insurance |
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| ZHAO Yun.Governance mechanism of medical quality risk under prepaid mode of medical insurance[J].Chinese Hospitals,2013(11):36-39. |
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| Authors: | ZHAO Yun |
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| Institution: | ZHAO Yun(Public health and Management Institute, Youjiang Medical University for Nationalities, No.98, Chengxiang Road, Baise, 533000. Guangxi Zhuang Autonomous Region, PRC) |
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| Abstract: | Medical insurance prepaid system is the effective measure to control medical costs, but also the culprit to reduce the medical risk. Taking care of prepaid mode, is also the process of preventing the medical quality risks. Firstly, the paper analyzes the main form of medical quality risk under prepaid mode of medical insurance from the perspective of ＂more＂ and ＂less＂. Secondly, the paper expounds formation mechanism of medical quality risk under the medical insurance prepaid mode from two aspects including management pattern and the incentive mechanism; Finally, the paper puts forward medical quality risk governance mechanism under the medical insurance prepaid mode from the perspective of equilibrium of responsibilities, rights and interests. |
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| Keywords: | medical insurance prepaid mode medical quality risk governance mechanism |
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