耗材(药品)治理改革的实践与探究——以南京市医保部门实施集中结算为例

刁仁昌, 王国宝, 王阳, 卢旻, 丁雪清, 刘俊

中国医疗保险 ›› 2022, Vol. 0 ›› Issue (6) : 54-59.

中国医疗保险 ›› 2022, Vol. 0 ›› Issue (6) : 54-59. DOI: 10.19546/j.issn.1674-3830.2022.6.011
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耗材(药品)治理改革的实践与探究——以南京市医保部门实施集中结算为例

  • 刁仁昌, 王国宝, 王阳, 卢旻, 丁雪清, 刘俊
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Practice and Exploration of Consumables/Drugs Governance Reform——Taking the Implementation of Centralized Settlement by Nanjing Medical Insurance Department as an Example

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摘要

药品耗材治理改革是降低公众就医用药负担的重大举措之一,而费用结算作为耗材治理进一步突破的关键环节,目前还是改革的空白点。本文分析了南京市耗材(药品)的结算现状、存在问题、具体举措及实施成效,下一步南京市将继续完善平台建设、加强全流程监管。

Abstract

The reform of consumables/drugs management is one of the major measures to reduce the public burden on medical drugs. As a key link for further breakthroughs in consumables management, cost settlement is still a blank spot in the reform. This paper analyzes the current situation and existing problems of consumables/drugs settlement in Nanjing, and exemplifies specific measures and implementation results for the difficulties. The paper proposes that Nanjing will continue to improve the platform construction and strengthen the supervision of the whole process in the next step.

关键词

药品耗材治理改革 / 医保部门 / 集中结算 / 阳光监管平台 / 结算五率

Key words

consumables/drugs governance reform / medical insurance department / centralized settlement / sunshine supervision platform / settlement rate

引用本文

导出引用
刁仁昌, 王国宝, 王阳, 卢旻, 丁雪清, 刘俊. 耗材(药品)治理改革的实践与探究——以南京市医保部门实施集中结算为例[J]. 中国医疗保险. 2022, 0(6): 54-59 https://doi.org/10.19546/j.issn.1674-3830.2022.6.011
Practice and Exploration of Consumables/Drugs Governance Reform——Taking the Implementation of Centralized Settlement by Nanjing Medical Insurance Department as an Example[J]. China Health Insurance. 2022, 0(6): 54-59 https://doi.org/10.19546/j.issn.1674-3830.2022.6.011
中图分类号: F840.684C913.7   

参考文献

[1] 国务院办公厅关于完善公立医院药品集中采购工作的指导意见. 中华人民共和国国务院公报, 2015(07): 第25-28页.
[2] 国务院办公厅关于印发治理高值医用耗材改革方案的通知. 中华人民共和国国务院公报, 2019(23): 第15-20页.
[3] 孙长胜与张寒菊, 张家口市药品集中采购直接结算的实践探索. 中国医疗保险, 2022(02): 第66-69页.
[4] 南京市人民政府.市政府关于推进市属三级医疗机构药品集中托管工作的实施意见.[EB/OL]. http://www.nanjing.gov.cn/zdgk/200805/t20080528_1054971.html.
[5] 南京市医疗保障局.关于开展医用耗材集中采购工作的实施意见.[EB/OL]. http://ybj.nanjing.gov.cn/gkml/201909/t20190905_1646004.html
[6] 南京市医疗保障局.关于建设南京市医用耗材阳光监管平台的实施方案.[EB/OL]. http://ybj.nanjing.gov.cn/gkml/201909/t20190905_1646030.html
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