中国医疗保险
中國醫療保險
중국의료보험
CHINA HEALTH INSURANCE
2014年
4期
9-12
,共4页
李成志%段光峰%李建梅%姚红
李成誌%段光峰%李建梅%姚紅
리성지%단광봉%리건매%요홍
医疗保险%特殊药品%高价%管理
醫療保險%特殊藥品%高價%管理
의료보험%특수약품%고개%관리
medical insurance%medicine%high-price%administration
近年来,部分临床上必须使用、疗效确切、价格昂贵的药品被纳入医保药品目录,然而部分定点医疗机构不配备或让病人自费购买这些药品,患者对此投诉较多。本研究对这类医保特殊药品进行了合理界定和分类,分析了这些药品在使用过程中产生矛盾的原因,并初步测算了医保特殊药品的年度费用。最后,结合本市实际提出解决医保特殊药品问题的政策建议。
近年來,部分臨床上必鬚使用、療效確切、價格昂貴的藥品被納入醫保藥品目錄,然而部分定點醫療機構不配備或讓病人自費購買這些藥品,患者對此投訴較多。本研究對這類醫保特殊藥品進行瞭閤理界定和分類,分析瞭這些藥品在使用過程中產生矛盾的原因,併初步測算瞭醫保特殊藥品的年度費用。最後,結閤本市實際提齣解決醫保特殊藥品問題的政策建議。
근년래,부분림상상필수사용、료효학절、개격앙귀적약품피납입의보약품목록,연이부분정점의료궤구불배비혹양병인자비구매저사약품,환자대차투소교다。본연구대저류의보특수약품진행료합리계정화분류,분석료저사약품재사용과정중산생모순적원인,병초보측산료의보특수약품적년도비용。최후,결합본시실제제출해결의보특수약품문제적정책건의。
In recent years, some medicines, which had clinical necessities, curative effectiveness but high price, were included in the medical insurance medicine list. However, some appointed hospital did not provide these medicines or let patients buy them at their own expense, which resulted in many complaints from patients. This study defined and classified these medicines, analyzed the causes of the contradiction in their usage, and initially estimated their annual cost. Finally, based on the actual situation in Shanghai, we put forward some suggestions to solve these problems.