医保改革对医疗机构的影响

目的:从医疗服务供方的角度了解医保改革对医疗机构产生的作用和影响,为完善有关改革措施提供参考依据。方法:收集有关文献并采用定性调查的方法选取不同级别、不同类型医疗机构的管理和医务人员进行专题小组访谈和个别访谈。结果:医保改革促进了卫生服务的发展,也加剧了医疗机构之间的竞争;医保额度和有关指标的限定使医院的业务收入增幅有所下降,并促发了新矛盾的出现。结论:医保改革取得了一定成效,但医院在改革中呈现出压力过大、动力不足的状态,要发挥社会各方的作用,共同推进改革的顺利进行。

Voice from health services providers for impacts of health insurance reform

Objectives:To better understand the views on health insurance reform and its impacts on hospitals operation form health staff perspective, and to provide evidence for comprehensive assessment combining other stakeholders. Methods: Focus group discussion and key informant interviews were applied in different sectors. Results:It demonstrated that the reform has accelerated the development of health services, and intensified the competitions among hospitals. But some rules influenced revenue increase of the hospitals, and some new conflicts revealed; new classification and application of medicine impacted on the community health service centers from two aspects. Conclusions:Health services providers recognized the achievement of the reform, but there were also some problems in practice, such as controlling medical fee increasing, much pressure and little motivation on hospitals.