广东医疗保障体制的优化探析

　　Abstract

The medical insurance system plays a vital role in the social security system. Its not onlymakes the society stable, but also reflects the fairness of the system. Due to the differences indifferent regions, national conditions, history and cultural concepts, various medical insurancesystems in the world are formed. Compared with the basic system of the national level, theregional medical insurance system in Guangdong will be✪ more flexible in reference to the systemreform and the formulation of relevant policies. As a populous province in the country, with theconcept of people-oriented, the successive Guangdong provincial government attaches greatimportance to the reform and construction of the medical and health service system. However,with the continuous development of the medical needs of the residents in the province, somehistorical problems left by the medical and health system and the gap of economic developmentin different regions, the medical security system in Guangdong still faces the problems of thedivision of urban and rural areas and the imbalance of the responsibility for raising funds formedical insurance, which leads to the insurance of the large diseases of the urban and ruralresidents in some areas. At the stage of institutional exploration, many problems remainunsolved. In this regard, the reform of the medical security system is becoming increasinglyurgent. Domestic scholars have studied the advanced practice of the medical insurance system indeveloped countries such as Britain, the United States and Germany. Although the 웃experience ofthe developed countries are good for learning.Beacuse of the historical culture and the economicdevelopment level, whic❤h can be used to learn from the advanced practice of the foreign medicalsecurity system in Guangdong province,is very limited. Geography, blood ties, and religiousrelations between Guangdong and Hong Kong are reflected not only in geographical areas ofSouth of the Five Ridges, but also in cultural, economic and social aspects of each other forhundreds of years. Hongkong basically follows the advantages of the health service system of thewhole people in the UK. Therefore, in comparison, the important study of this article is topromote the reform of the medical security system in Guangdong and improve the feasibility ofthe reform of the medical security system in Guangdong by drawing on the medical securitysystem in Hongkong. In this paper, the medical security system of Guangdong and Hong Kong,which is reflected by the two countries, is taken as the research ob©ject. With the different medicalsystems promoted by the two governments as the research angle, the supply system, themanagement system, the fund raising and operation system of the two places are understoodthrough a comprehensive comparison of the reform mode and the development status of themedical security system in Guangdong and Hong Kong. The differences and so on, clarify theComparative study of medical security systemin Guangdong and Hong KongAuthor: Zhang Xiaoyan Major: Master of Public Administration Grade:2015Specialty: Social security and social policy Tutor: Zhang Xiong ,Yi Xuefeng Key words: healthcare system , comparative studies, Guangdong and HongKong;differenceadvantages of Hongkong medical security system, and then put forward to draw lessons fromHongkongs development experience, explore the future direction of medical reform inGuangdong, solve the major livelihood issues of difficult to see and expensive in the province,guarantee the residents medical needs, and provide suggestions for improving the medicalsecurity system in Guangdong.

Key words: healthcare system , comparative studies, Guangdong and HongKong;difference

　　目 录

摘 要

Abstract

绪论.

（一）选题背景和意义

1．选题背景.

2．研究目的和意义 .

　　（二）研究现状

1．国外研究综述 .

2．国内研究综述 .

　　（三）研究的方法

1．文献资料法.

2．比较研究法.

　　（四）研究内容、创新及不足

1．研究内容.

2．研究的创新与不足 .

　　一、基本概念界定与研究理论基础.

（一）基本概念的界定

1．社会保障制度 .

2．医疗保障制度 .

（二）研究的理论基础

1．福利经济学理论 .

2．国家干预理论 .

3．外部性理论.

（三）医疗保障制度对社会经济发展的影响

1．医疗保障制度对社会的影响 .

2．医疗保障制度对经济的影响 .

二、粤港医疗保障制度的发展历程与基本现状

（一）香港医疗保障制度的发展状况

1、香港医疗保障制度的发展历程 .

2、香港医疗保障制度的发展现状 .

（二）广东医疗保障制度的发展状况

1．广东医疗保障制度的发展历程 .

2．广东医疗保障制度的发展现状 .

　　三、粤港医疗保障制度的比较分析.

（一）粤港医疗保障制度目的、内容、水平与覆盖面的比较 .

1．医疗保障制度目的的比较 .

2．医疗保障制度内容的比较 .

3．医疗保障制度水平的比较 .

4．医疗保障制度覆盖面的比较 .

　　（二）医疗保障制度管理体制的比较

1．医疗保障体制框架的比较 .

2．医疗保障财务管理的比较 .

3．医疗保障管理改革趋势的比较 .

（三）医疗保障资金运营体制的比较

1．医疗保障支出在财政支出中的地位比较 .

2．医疗保障资金来源与筹资模式比较 .

　　（四）医疗保障制度效益的比较

1．医疗保障社会效益的比较 .

2．医疗保障经济效益的比较 .

3．商业医疗保险的发展比较 .

4．社区卫生服务的发展比较 .

　　四、粤港医疗保障制度差异性的根源分析

（一）制度因素

1．制度未能很好适应流动人员特点和需求 .

2．制度未能很好地控制药物价格 .

（二）经济因素

1．生产力发展水平不同 .

2．经济体制不同 .

（三）文化因素

1．文化差异.

2．认知差异.

（四）医疗资源配置因素

1．卫生资源

2．医疗服务.

3．收支与费用.

五、完善广东医疗保障制度的对策建议

（一）做好制度管理

1．调整公立医院的制度 .

2．建全实施中的监测制度 .

3．健全健康信息化制度建设 .

4．大力发展商业保险的配合补充制度 .

（二）提高社会经济效益

1．完善药品集中采购交易模式 .

2．优化特殊人群基本药物保障 .

3．创新医疗卫生服务供给模式 .

4．定期对医务人员进行思想教育 .

　　（三）加强文化交流

1．加大医保认知的宣传 .

2．积极学习参考 .

3．深化交流合作 .

（四）完善资源配置

1．提升基层医疗卫生服务能力 .

2．促进粤港澳大湾区医疗卫生深度融合发展 .

六、结束语.

参考文献.