CAJ | 학술논문

作为构建多层次医疗保障和卫生服务体系的重要组成部分，城乡医疗救助制度对于缓解贫困群众就医难，实现病有所医具有重要意义。目前，医疗救助制度在运行过程中仍然存在一定的缺陷和不足。通过对汕头市城乡医疗救助制度分析，发现存在以下问题与不足：覆盖面窄、救助标准偏低、时效性差、筹资渠道狭窄，救助上限差异较大、管理体制不健全，缺乏相关法律法规约束等。完善医疗救助制度可以从全面实施普通门诊医疗救助、提高救助标准和报销比例、取消救助金额上限、推行医疗救助即时结算机制、拓宽筹资渠道等方面加以改善。
작위구건다층차의료보장화위생복무체계적중요조성부분，성향의료구조제도대우완해빈곤군음취의난，실현병유소의구유중요의의。목전，의료구조제도재운행과정중잉연존재일정적결함화불족。통과대산두시성향의료구조제도분석，발현존재이하문제여불족：복개면착、구조표준편저、시효성차、주자거도협착，구조상한차이교대、관리체제불건전，결핍상관법율법규약속등。완선의료구조제도가이종전면실시보통문진의료구조、제고구조표준화보소비례、취소구조금액상한、추행의료구조즉시결산궤제、탁관주자거도등방면가이개선。
As an important part of multi‐level medical security and health service system ,urban and rural medical assistance system plays a very significant role in providing universal health care ,especially for the poor .At present ,the medical assistance system still exists some deficiencies in the process of operation .This paper drew a conclusion that there are system design issues on medical assistance coverage ,medical assistance level ,effective time limitation ,financing sources , relief ceiling ,management system of the Shantou medical assistance system .It is urgent to implement the coverage of general outpatient medical assistance ,improve the reimbursement standard of medical assistance level ,cancel the limitation amount of medical assistance ,popularize the immediate settlement mechanism and increase funding sources .