慢性病和部分特殊性疾病的门诊维持性治疗给患者带来较为沉重的经济负担,急需医保发挥更充分的调节和保障作用。目前的慢特病门诊保障制度大都处于地市级统筹阶段,随着异地就医的增多,各地较大的政策差异影响了制度的便利性,急需从省级层面进行规范统一。本文分析了贵州省规范统一慢特病门诊保障制度的主要内容、取得的成效和启示,在此基础上围绕优化医保慢特病管理路径提出制度完善建议,以推动医保慢特病管理从单方费用管控向医患保协同健康管理模式转变。本研究旨在为其他省份规范统一慢特病门诊保障制度提供参考借鉴。

Outpatient maintenance treatment of chronic diseases and some special diseases increasingly constitutes a heavy burden on patients, and it is in urgent need for healthcare security to play a fuller role in regulation and guarantee. At present, the outpatient guarantee system of chronic and special diseases is mostly in the stage of prefecture-level coordination. With the increase of medical treatment in different places, the large policy differences affect the convenience, and it is urgent to be standardized and unified at the provincial level. This paper analyzes the main contents, achievements and enlightenment of standardizing and unifying the outpatient guarantee system of chronic and special diseases in Guizhou Province. On this basis, this paper puts forward system improvement suggestions around optimizing the management path of healthcare security chronic and special diseases, so as to promote the transformation of healthcare security chronic and special disease management from unilateral cost control to doctor-patient insurance collaborative health management mode. The study aims to provide reference for the standardization of the outpatient guarantee system in other provinces.