Incorporating Insights from Japan's Health Insurance Fund Regulation into China's Framework
- VernacularTitle:日本医保基金监管模式对我国的经验借鉴
- Author:
Yuhao WANG
1
;
Yuanyi WU
;
Jieying HUANG
;
Yuqi GU
;
Jialong WANG
;
Nana LU
;
Wei XU
Author Information
1. 中国药科大学国际医药商学院 江苏 南京 211198
- Keywords:
health insurance fund supervision;
supervision model;
experience learning
- From:
Chinese Health Economics
2024;43(11):91-96
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.
