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作为医疗服务供求双方的制度安排,公立医院体制机制与医疗保险付费方式必须适配才能发挥各自的功能。功能的协同和互补是两者适配的主要依据,据此,有两大适配模式:一是公立医院绩效型行政化体制与医疗保险后付费方式的组合;二是公立医院治理型市场化机制与医疗保险预付费方式的组合。
As the institutional arrangement of both medical service supply and demand, the institutional mechanisms of public hospitals and medical insurance payment methods must be adapted to play their respective functions. The synergy and complementarity of functions are the main basis for the adaptation of the two. Therefore, there are two adaptation modes: one is the combination of the performance-based administrative system of public hospitals and the post-mortem scheme of medical insurance; the other is the public hospital governance-oriented marketization A combination of mechanics and medical insurance pre-paid.