摘要:医疗保险中的道德风险是医疗机构所面临的一个最重要的风险之一。此项研究便是找出导致道德风险的根源所在,从而提出针对性的防范建议,平衡缓解医疗费用的增长,使医疗机构的资源配置达到最优状态,提高对有限资源的利用率,防止对医疗卫生资源的过度消耗。57666
本文以我国医疗保险领域的供方和需方道德风险问题为研究对象,在回顾国内外对社会医疗保险中道德风险研究的基础上,运用统计学、社会学、经济学等学科的相关理论,揭示供方和需方道德风险在医疗保险中的表现与原因,其中具体表现有:由供方诱导的道德风险如医生过度开药、过度检查和开某种对其存在利益的药品。在需方层面,存在着过度需求,骗保,一卡多用等现象。
分别提出针对以上现象找出导致其产生的原因,并从医生的薪酬结构改变、药品政策改革、支付方式改革和监管改革方面提出了针对供方医疗保险道德风险的防范建议。从制度、技术、监管,惩处方面提出了针对需方道德风险的防范建议。
毕业论文关键词:医疗保险;道德风险;防范
Moral hazard in medical insurance and its preventive measures in our country
Abstract: The risk of moral hazard in medical insurance is medical institutions are facing a one of the most important risks. The study is to find out the root cause of lead to moral hazard, which produced some of the reasons for the risk of moral hazard, these reasons have vulnerabilities that policy at the same time .So as to put forward the corresponding prevention advice, balance reduce growth in medical costs, make the allocation of resources to achieve the optimal state of medical institutions, improve the utilization of limited resources, prevent the excessive use of healthcare resources.
In this paper, in the field of medical insurance in China supplier and buyer's moral hazard problem as the research object. Outside of moral hazard in social medical insurance research, on the basis of applying the management, sociology, economics and so on .Of the relevant theory, the prescriptions in the field of social medical insurance the moral hazard problem for points analysis, through mining the prescriptions and risk for the moral reveal the deep mechanism of the supplier and buyer's moral hazard in medical insurance.
Performance, such as moral hazard induced by the supplier as the doctor prescribed some over-prescribing drugs, and excessive examination and for the interests of the existence of drugs. At the buyer's level, there is excess demand, insurance fraud, the phenomenon such as a card holders were put forward in view of the above phenomenon, from the doctor salary structure change payment, drug policy reform, reform and regulatory reform put forward aimed at the supplier's recommendations to prevent moral hazard of medical treatment insurance. From system, technology, supervision and punishment aspects according to buyer's Suggestions to prevent the risk of moral hazard.
Key words: Medical insurance ; The risk of moral hazard ; Preventive measures
目录
一、绪论 1
(一) 道德风险的概念及表现形式 1
1、 道德风险的概念 1
2、 表现形式 1
(二) 道德风险产生的影响 2
(三) 研究目的 2
(四) 研究意义 2
二、研究方法 3
(一) 文献研究 3
(二) 实证研究