【摘要】：隨著醫(yī)療保險的逐步發(fā)展，醫(yī)保的覆蓋面愈來愈大，全民醫(yī)保時代已悄然降臨。醫(yī)療保障體系的完善，不僅是國計民生的主要內容，也是彰顯社會主義優(yōu)越性的重要方面。醫(yī)保制度是否健全，直接影響著百姓的日常生活，乃至影響整個國家的穩(wěn)定。隨著我國的經濟發(fā)展，醫(yī)療制度也隨之逐步改革。由于其改革與百姓生活密切相關而被廣泛關注，盡管在改革的過程中飽受各方面的爭議，，但結果還是卓有成效，衛(wèi)生事業(yè)實現了快速的發(fā)展，醫(yī)療制度也取得了廣泛的認可。 本文討論的目的在于，在系統(tǒng)回顧和分析國內外醫(yī)療保障制度的基礎上，系統(tǒng)分析醫(yī)、患、保三者的利益格局，探尋實現三方共贏的路徑。在保證政府醫(yī)療費用支出平衡的基礎上，使百姓能夠享受更優(yōu)質的醫(yī)療服務。 本文從醫(yī)院管理者的角度,對長春市醫(yī)保在解放軍四六一醫(yī)院運行的個案研究進行分析，深入討論了醫(yī)院在面對新的形勢時，主動適應醫(yī)保政策和醫(yī)療競爭的必然趨勢。管理行為對醫(yī)療保險制度的改革將會產生重要的影響，醫(yī)院在適應醫(yī)保制度改革的同時，醫(yī)療保險制度的逐步推進和不斷完善又作用于醫(yī)院的可持續(xù)發(fā)展。因此，研究醫(yī)院與醫(yī)療保險相輔相成、相互支持，既有依賴又有相互制約的對立統(tǒng)一關系，尋求兩者之間的既能發(fā)展各自內涵，又能拓展各自外延的機制已是當前政府、衛(wèi)生行政部門、醫(yī)療保險和醫(yī)院管理者共同關注的熱點。本文在研究分析醫(yī)療保險與醫(yī)院的相互關系和管理行為的互補性的同時，還為今后兩者協(xié)調發(fā)展提出了對策和建議，以探索適合我國國情的新型醫(yī)院與醫(yī)療保險共同協(xié)調發(fā)展的途徑。
[Abstract]:With the gradual development of medical insurance, the coverage of medical insurance is increasing, and the era of universal health insurance has come quietly. The perfection of medical security system is not only the main content of national economy and people's livelihood, but also the important aspect of showing the superiority of socialism. Whether the health insurance system is sound or not directly affects the daily life of the people and even the stability of the whole country. With the economic development of our country, the medical system has been reformed step by step. Because its reform is closely related to the life of the people, it has been widely concerned. Although it has been controversial in all aspects in the process of reform, the results are still fruitful, the health care has achieved rapid development, and the medical system has also been widely recognized. The purpose of this paper is to systematically analyze the benefit pattern of medical care, patient and insurance on the basis of systematic review and analysis of the medical security system at home and abroad, and to explore the way to realize the win-win situation among the three parties. On the basis of ensuring the balance of government medical expenditure, people can enjoy better medical service. From the point of view of hospital manager, this paper analyzes the case study on the operation of Changchun medical insurance in PLA 4 / 61 hospital, and discusses in depth the inevitable trend of hospital actively adapting to medical insurance policy and medical competition in the face of new situation. The management behavior will have an important influence on the reform of the medical insurance system. While the hospital adapts to the reform of the medical insurance system, the medical insurance system will be promoted and perfected step by step, and it will play an important role in the sustainable development of the hospital. Therefore, the study of hospital and medical insurance complement each other, support each other, both rely on and restrict the unity of opposites, seek the mechanism between the two can both develop their connotations and expand their respective extension of the mechanism is the current government, Health administration, medical insurance and hospital administrators are the hot spots of common concern. While studying and analyzing the relationship between medical insurance and hospitals and the complementarity of management behavior, this paper also puts forward some countermeasures and suggestions for the coordinated development of medical insurance and hospitals in the future. In order to explore a new type of hospital and medical insurance to develop in harmony.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：F842.684

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