广西城乡基本医疗保险异地就医管理研究

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1、万方数据用为主，且住院费用中城镇职工的统筹支付比例明显高于城镇居民。在城镇职工中，退休人员异地就医费用高于在职人员，就医流向主要在省内。城镇居民医疗保险中异地转诊人员所占比例较大，而异地急诊和异地居住所占比例较小。城镇职工医疗保险中，异地安置退休比例均最大，但人数呈现逐年下降的趋势；异地转诊人员呈逐年增加趋势，异地急诊和异地居住所占比例较小。监管中主要存在的问题有：医疗保险政策不统一引起的效率和公平缺失；异地就医监管成本高且难度较大，易产生道德风险；参保人报销困难，报销周期较长，经济负担较重。政策建议

2、：结合相关数据分析结果针对存在的问题提出的对策有提升异地就医问题的解决理念，促进医疗保险公平；逐步整合医疗保险制度，实现城乡医保制度的无缝对接；不断加强医疗保险经办能力和信息化建设，实现社会保障卡一卡通；建立健全全国协作机制，推动跨省异地就医结算便利化；合理调配医疗资源，促进城乡医疗服务均等化。【关键词】城乡基本医疗保险，异地就医，管理；万方数据亡酉缝垒基盔医堑堡堕昱垫塾匿萱堡亟塑垫!i昼型!±芏焦迨塞THERESEARCHOFMANAGE]MENTOF0FF—SITEMEDICALTREATMENT

3、INGUANGXIURBANANDRI瓜AI．BASICMEDICALINSI瓜ANCEABSTRACTBackground：healthinsuranceasasocialsecuritysysteminolleofthemostimportant,isplayingadjustthemcomegap,thero／eofsocialsecurityandfair,butalsoinlargemeasurecontributedtotheeconomicandsocialdevelopmentandp

4、eople’Shealth．ReformofMedicalInsuranceSystemin”widecoverage，coversbasic，multi．1evel，sustainable”policyguidanceprogresses，studyandsolvemedicalinsurancesystem，thesize，structure，formhowtoachieveeconomicandsocialdevelopmentandadaptationofmodemproblems．Inrec

5、entyearsasincreasingandimprovingthepeople’Shealthcareneedsofpopulationmovements，healthcareunbalancedallocationofresourceshavebecomeincreasinglyprominent，remotemedicalactsoccurmorefrequently,healthinsuranceagenciesmeNcNbnlingandmanagementindifferentplace

6、sthereisabigdifficultyonhowtocarryoutscientificandeffectivemanagementofremotemedicalhealthinsurancesyStembecomeanurgentproblem，Purpose：ThispaperaimstoChinaandGuangxiurbanandruralbasicmedical3万方数据￡亘堑垒茎奎医堕堡险显丝塾医篮堡堑壅2Q!i昼塑±茎鱼丝：墨insuranceforremotemedicalref

7、ormanddevelopmentprocessofcombingandobjectiveanalysisofthecurrentsituationandthemanagementstatusquoofGuangxiurbanandruralbasicmedicalinsuranceforremotemedicalservicereform，findGuangxiremotemedicalfaceproblemsandregulatorydifficulties，combinedwiththerefo

8、rmoftheexperienceofothercountriesandprovinces，targetedsolutionputforwardideasandcountermeasures．Methods：Inthispaper，literatureresearchapplicationresearchstatusacrossthecountry．understandthehistory，developmentandstatusofremotemedi