江汉油田医疗保险总额控制付费方式探讨

摘要

油田医疗保险付费方式经历了几次变革 ,从最初的按项目付费到单病种付费 ,直至目前的总额控制 ,多种付费方式的灵活配置 ,对油田医保基金合理使用、医疗机构规范诊疗起到了至关重要的作用.本文通过对总额控制付费方式的主要做法、利弊分析、取得成效等各方面的深入探讨 ,以期进一步提高油田医疗保险管理服务水平.%The payment method of medical insurance in Jianghan Oilfield has gone through changes from initial pay-ment according to medicine items to single -disease payment ,and up to present total -controlled payment .The flexible combination of multiple payment methods has played a critical role in rationally using medical insurance fund and standardizing illness diagnoses .This paper explores the total-controlled payment including its main methods , its advantages and disadvantages as well as its result ,hoping to improve management and service of medical insur-ance in Jianghan Oilfield .