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"防返贫"医疗保障长效机制的构建OA

The construction of a long-term mechanism for preventing poverty reversion through the medical security:based on practice in Yunnan Province

中文摘要英文摘要

乡村振兴背景下,医疗保障"防返贫"长效机制由扶贫特惠型向三重保障常态化、普惠型模式过渡.云南省在参保扩面、稳定待遇、动态监测和精准帮扶方面,通过建机制、优服务、见成效,守牢"防返贫"底线,经验可供借鉴推广.建议下一步政策优化调整可从健全完善参保相关制度、强化主动发现机制、增强基层医保业务能力、实施综合帮扶降低自付费用和加强基层门诊慢特病服务能力 5 个方面着力,推动医疗保障"防返贫"长效机制更加公平、协同和高效.

Under the background of rural revitalization,the long-term mechanism of medical security for"preventing poverty reversion"changes from the poverty-alleviation preferential type to the normalized and universal triple model.Yunnan Province has established mechanisms,optimized services,and produced a remarkable effect in aspects such as expanding insurance participation,stabilizing benefits,dynamic monitoring,and precise assistance.It has firmly held the bottom line of"preventing poverty reversion",and its experience can be used for reference and promotion.It is recommended that in the next step of policy optimization and adjustment,efforts can be made in five aspects:improving the long-term mechanism for insurance participation,strengthening the active discovery mechanism,enhancing the business capabilities of medical insurance agencies,implementing comprehensive assistance to reduce self-financed medical expenses for patients,and strengthening outpatient service for chronic and special diseases in primary healthcare institutions,so as to make the long-term mechanism of medical security for"preventing people from slipping to poverty"more fair,coordinated,and efficient.

陈颖

昆明医科大学发展改革研究中心,云南 昆明 650500

社会科学

医疗保障"防返贫"长效机制成效构建

medical securitylong-term mechanism to prevent poverty reversionachievementsimprovements

《农村·农业·农民》 2025 (7)

90-93,4

云南省社科规划社会智库项目(SHZK2022325)昆明医科大学一流学科团队建设项目(2024XKTDPY13)

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