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随着厦门市经济发展、社会进步和人民生活水平的提高,卫生服务范畴不断拓展,医疗卫生服务逐渐从医院走向社区,社区卫生服务因此应运而生。社区卫生服务机构的建立和健全使社区卫生工作的优势逐渐显凸,社区卫生服务以成本低、广覆盖、高效益、方便群众等特点,以“低水平、广覆盖”的基本医疗为特色,符合职工医疗保险制度的原则。面对广大居民对社区卫生服务需求的增长,如何为社区居民中的参保职工提供方便、快捷、高效、综合和连续的卫生服务,已被各级政府提到议事日程。为积极稳妥推进社区卫生机构的医疗保险定点工作,保证社区卫生工作与基本医疗保险工作合理衔接、共同发展,已成为社会共同关注的问题。为给社区卫生服务机构医疗保险定点提供科学依据,我们对全市社区卫生服务供需状况进行了调查。在调查研究的基础上,严格按照医疗保险的有关要求对申请医保定点的社区卫生机构进行考核审定,坚持成熟一个、定点一个、巩固一个。几年来共确定医保定点的社区卫生和社区卫生性质医疗机构近50个,这些定点的社区卫生机构能紧紧把握“基本医疗”这个共同支点,合理规范医疗行为,注重成
With the improvement of economic development, social progress, and people’s living standards in Xiamen, the scope of health services has continued to expand, and medical and health services have gradually moved from hospitals to communities. Community health services have therefore emerged. The establishment and improvement of community health service institutions have made the advantages of community health work increasingly prominent. Community health services are characterized by low cost, wide coverage, high efficiency, and convenience for the masses, and basic medical services with low level and wide coverage are Features, in line with the principle of medical insurance system for employees. Faced with the growing demand for community health services from the general public, how to provide convenient, fast, efficient, comprehensive and continuous health services for the insured employees in the community has been referred to the agenda by governments at all levels. It has become a common concern for the society to actively and steadily push forward the fixed-point work of medical insurance in community health institutions and ensure that community health work and basic medical insurance work are properly connected and developed together. In order to provide scientific basis for the medical insurance of community health service institutions, we investigated the supply and demand of community health services in the city. Based on the investigation and study, the community health agencies that apply for medical insurance are strictly examined and approved in strict accordance with the relevant requirements of medical insurance, and one mature, one fixed, and one consolidated are adhered to. In the past few years, a total of nearly 50 community health and community health medical institutions have been designated for medical insurance. These designated community health agencies can firmly grasp the common fulcrum of “basic medical care,” and reasonably regulate medical practices, focusing on