CAJ | 학술논문

临床治疗指标、医疗卫生支出、药物经济学性价比、生命质量指数是国内外制定和调整医保药品目录的主要依据.医保药品目录效果的影响因素包括药品与临床使用符合度、患者医疗费用负担减轻程度、医疗行为控制程度、医保基金运行风险等.经济水平、医保制度、诊疗水平是影响医保药品目录使用的客观因素,医保管理水平、医患双方合理用药意识则是可控因素.
림상치료지표、의료위생지출、약물경제학성개비、생명질량지수시국내외제정화조정의보약품목록적주요의거.의보약품목록효과적영향인소포괄약품여림상사용부합도、환자의료비용부담감경정도、의료행위공제정도、의보기금운행풍험등.경제수평、의보제도、진료수평시영향의보약품목록사용적객관인소,의보관리수평、의환쌍방합리용약의식칙시가공인소.
The formulation of medical insurance drug catalogue at home and abroad is based primarily on clinical indicators, budget impact, pharmacoeconomics and quality of life. Influence factors of medical insurance drug catalogue include coincidence degree of drugs and clinical use, the level of reducing the medical cost burden on patients, the extent of controlling medical behavior and operation risk of medical insurance fund. Economic level, health care and the clinic level are objective factors which affect the implementation of medical insurance drug catalogue. The management level of medical insurance and rational use of drugs is controllable factors.