Research on the realization path of county health insurance strategic purchasing under the orientation of strengthening the primary health services
10.3969/j.issn.1674-2982.2024.07.001
- VernacularTitle:强基层导向下县域医保基金战略性购买的实现路径研究
- Author:
Rui-Bo HE
1
,
2
;
Lin-Bin LUO
;
Yi-Qing XING
;
Hao-Miao LI
;
Liang ZHANG
Author Information
1. 武汉大学政治与公共管理学院 湖北武汉 430072
2. 湖北经济学院医疗保险改革协同创新中心 湖北武汉 430205
- Keywords:
Primary health;
Strategic purchasing;
Synergy of health insurance and health services
- From:
Chinese Journal of Health Policy
2024;17(7):1-7
- CountryChina
- Language:Chinese
-
Abstract:
The health insurance fund acts as the resource for the survival of medical institutions.However,it has shown a development trend of structural friction in the county.By analyzing the relationship between strategic purchasing and the function of health insurance system,this study clarifies the central position of payment and the roles of fund allocation and service compensation.By analyzing the reasons of the imbalance between the health insurance fund and primary services in the county,this study proposes that the strategic purchasing of health care services in the county needs to take into account both the front-end of payment-allocation,and the front-end of service--primary.On this basis,this study put forwards the strategic purchasing of primary health services,which aims to cut off the fund"competition"channel between hospitals and primary health care institutions by changing the fund distribution method;to guide the primary health care to proactively identify and satisfy the changes of the county's residents'service needs by adjusting the service compensation method;and supplemented with joint advocacy and collaborative supervision.The strategic purchasing of primary health services will gradually promote the development of primary health services in the county from sustainable to high-quality.
