关于按服务项目支付的探讨.pdfVIP

2 1 1 ( ) Vol 21 No 1 2008 3 Journal of Beijing University of Aeronautics and Astronautics( Social Sciences Edition) March , 2008 高庆波 ( 中国人民大学 劳动人事学院, 北京 100872) : 按服务项目支付是中国医疗保险实践广泛 用的结算方式文章分析了在医疗保险中医院 患者医疗保险经办机构各自的目标行为以及在不同的报销模式下的行为选择, 并进一步得出, 医疗保 险经办机构 用不同的报销模式将导致不同的主体间关系不同的医疗保险满意度以及医疗资源利用 水平中国医疗保险事业缺乏西方国家成熟的商业保险行业组织以及相应的经验和信息积累, 变更医 院的目标函数和约束条件是更加合理地利用医疗资源的关键 : 医疗保险; 按服务项目支付; 行为分析 : C979 : A :( 2008) Pay on Fee in China GA O Qingbo ( School of Labor and Human Resources, Renmin Univ ersity of China, Beijing 100872, China) Abstract: Pay on fee is a w idely used w ay of settlement in the medical security system of China This paper analyzes the objectives and action choices under different reimbursement patterns taken by hosp itals, patients and m edical secu rity organizations Further analysis shows that diff erent reimbursement patterns taken by the m edical security organiza tions w ill lead to different interrelationships, different satisf ied degrees and utilization levels of medical resources Lack of business insurance organizations and management experience and inform ation accumulation , the settlement w ay of pay on f ee in China has to be used for a long tim e The key to utilize m edical resources more prop erly is to modify ob ject functions and constraint conditions of hosp itals Key words: medical security; pay on f ee; action analysis , , [ 1] [ 2] [ 3] [ 4] , , ,