本文選題：城鎮(zhèn)職工 + 醫(yī)�；�　； 參考：《沈陽師范大學》2017年碩士論文

【摘要】：本文以我國三大醫(yī)療保險體系中最主要的城鎮(zhèn)醫(yī)療保險為例,通過對醫(yī)改試點城市鞍山市城鎮(zhèn)職工醫(yī)療保險運行中保險基金支付方式的調研分析,提出其運行中存在的問題,重點采用調查法、分析比較法及案例分析法等來分析目前城鎮(zhèn)職工醫(yī)�；鹬Ц斗绞襟w系、存在的問題分析比較得出結論;通過查閱國內外參考文獻,借鑒成功經驗提出對策。本文研究結果顯示在醫(yī)療保險基金緊張的情況下,目前運行的按項目付費的醫(yī)療保險基金支付方式無法控制醫(yī)療費用的不合理增長,已經遠遠不能滿足廣大人民群眾就醫(yī)需求,急需構建一個在總額預付控制下以單病種付費為主的多元化支付體系,同時發(fā)揮政府主導作用,達到政府與市場、公平與效率、權利與義務的協(xié)調發(fā)展。本文共分緒論、城鎮(zhèn)職工醫(yī)�；鹬Ц斗绞降睦碚摶A、鞍山市城鎮(zhèn)職工醫(yī)�；鹬Ц兜默F狀及存在的問題、鞍山市城鎮(zhèn)職工醫(yī)保基金支付方式的調整對策、研究結論與未來展望五部分對上述問題進行闡述。本文創(chuàng)新點一是運用新古典經濟學的供給需求理論,設計需方、供方及醫(yī)療機構社會醫(yī)療保險費用控制的三個構成要素的醫(yī)療保險付費方式控制的概念框架,并分析其中存在的問題及其成因,在此基礎上借助羅斯福的社會保障思想、凱恩斯的國家干預思想、貝弗里奇報告中的福利國家思想,提出了問題的解決對策。二是以醫(yī)保試點城市鞍山市為研究對象,運用了實例調查的研究方法對醫(yī)療保險費用支付方式的現狀進行調查,并對調查結果進行實證分析并提出解決對策,所獲得的研究成果對于當前遼寧地區(qū)醫(yī)療保險費用支付方式的改革、緩解醫(yī)患矛盾提供了有效途徑和值得借鑒的參考。
[Abstract]:Taking the most important urban medical insurance in the three major medical insurance systems of our country as an example, through the investigation and analysis of the insurance fund payment methods in the operation of medical insurance for urban workers in Anshan City, a pilot city of medical reform, the problems existing in the operation of the insurance fund are put forward. This paper mainly adopts the investigation method, the comparative method and the case analysis method to analyze the current payment system of the medical insurance fund for the urban workers and staff, and draws a conclusion by analyzing and comparing the existing problems, and puts forward the countermeasures by consulting the domestic and foreign references and drawing lessons from the successful experience. The research results of this paper show that under the condition of tight medical insurance fund, the current payment mode of the medical insurance fund paid by the project cannot control the unreasonable increase of the medical cost, and it is far from being able to meet the needs of the broad masses of the people for medical treatment. It is urgent to construct a multiplex payment system under the control of total advance payment with single disease, and at the same time give play to the leading role of the government to achieve the coordinated development of government and market, fairness and efficiency, rights and obligations. This paper is divided into the introduction, the theoretical basis of medical insurance fund payment for urban staff and workers, the current situation and existing problems of medical insurance fund payment for urban workers in Anshan city, and the adjustment countermeasures of medical insurance fund payment method for urban workers in Anshan city. Research conclusions and future prospects of the five parts to elaborate on the above issues. The first innovation of this paper is to use the supply demand theory of neoclassical economics to design the conceptual framework of the medical insurance payment mode control which is composed of three elements of the social medical insurance expense control of the demand-side, the supply-side and the medical institution. Based on the analysis of the existing problems and their causes, the author puts forward the solutions to the problems with the help of Roosevelt's social security thought, Keynes's thought of state intervention, and the welfare state thought in Beveridge's report. Second, taking Anshan City, a pilot city of medical insurance, as the research object, using the research method of case investigation to investigate the current situation of medical insurance expense payment, and to make an empirical analysis on the results of the investigation and put forward some countermeasures to solve the problem. The research results provide an effective way and a reference for the reform of medical insurance payment mode and the alleviation of doctor-patient contradiction in Liaoning.
【學位授予單位】：沈陽師范大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：F842.684

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本文編號：1808947