CAJ | 학술논문

根据医疗服务体系目标模式和卫生筹资体系结构特点，提出公立医院的补偿渠道应以医疗服务收费为主，需联动提高医疗服务价格和加强药品管理，扭转不合理的医疗服务收费结构；补偿主体以医保为主，财政投入主要支持建设和发展，医保应支付大部分医疗费用；补偿方式上财政投入和医保支付应形成合力，体现规划导向与绩效导向。同时，需完善分级诊疗体系、规范公立医院诊疗行为和成本支出标准等配套措施，为公立医院补偿总量和标准核定提供支撑。
근거의료복무체계목표모식화위생주자체계결구특점，제출공립의원적보상거도응이의료복무수비위주，수련동제고의료복무개격화가강약품관리，뉴전불합리적의료복무수비결구；보상주체이의보위주，재정투입주요지지건설화발전，의보응지부대부분의료비용；보상방식상재정투입화의보지부응형성합력，체현규화도향여적효도향。동시，수완선분급진료체계、규범공립의원진료행위화성본지출표준등배투조시，위공립의원보상총량화표준핵정제공지탱。
According to the target-model of the health care system and characteristics of the health financing system,it is proposed in the paper that the charges of medical services should be the main revenue of public hospital compensation.Efforts should be made to adjust health care service prices and strengthen pharmaceutical management simultaneously so as to rebuild the structure of medical service charge.Medical insurance should make the majority in the compensation to cover most the medical expenses,with government subsidies supporting development.Both government financial investment and medical insurance should join their efforts for planning-guidance and performance-guidance.The authors also suggested to improve a graded and normative diagnoses and treatment system,regulate medical behaviors of public hospitals and their cost standards,justifying the total compensation and standard verification of such hospitals.