加拿大实验室诊断项目医保支付政策分析及启示

摘要

从医保制度背景、支付原则、范围和标准、支付方式及新实验室诊断技术支付情况等方面梳理了加拿大实验室诊断项目医保支付政策进展.并针对我国实验室诊断项目医保支付存在的主要问题提出:制定明确的实验室诊断支付政策;借鉴加拿大实验室诊断目录框架,引入限制条件及说明;建立卫生技术评估机制,为新技术报销决策提供支撑等建议.%The study depicted the medical insurance reimbursement policy on laboratory diagnostic service in Canada from the aspects of background of medical insurance system,reimbursement principle,scope and standards,pattern of payment,and reimbursement on new laboratory diagnostic technology.The main problems of laboratory diagnosis payment in China was analyzed,and suggestions were made,which included establishment of a clear reimbursement policy on laboratory diagnosis service;drawing lessons from Canadian on laboratory diagnostic directory framework,and introducing restrictions and explanations;establishment of a health technology assessment mechanism to support new technology reimbursement decision.