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总额预算支付制度限制了健保费用的总支出,相对值表制度确定了医疗服务项目的支付标准,两种制度的配合使用为台湾建立了公平合理的健保支付框架,对健保的良好运行和持久经营功不可没。本文通过对台湾地区此两种制度在健保支付方面的具体应用情况的介绍,并结合大陆地区试点城市类似模式的实施情况,对此模式提出思考与评价。
The total budgetary payment system limits the total expenditure on health insurance expenses. The relative value system defines the payment standard for medical service projects. The combination of the two systems sets up a fair and reasonable health insurance payment framework for Taiwan and provides a sound and healthy health insurance payment system for Taiwan. Endured. Based on the introduction of the specific application of these two systems in the area of health insurance payment in Taiwan and the implementation of similar models in the pilot cities in the mainland of China, this paper puts forward some thoughts and comments on this model.