关键词: font-size:medium, ">医联体；医共体；医保支付；支付方式改革；系统评价

Abstract: Objective： To Summarize the reform measures of the medical insurance payment methods in the medical groups in some regions of China， and systematically evaluate the results of the medical insurance payment methods reform， and provide a reference for further promoting the medical insurance payment methods reform in the medical groups. Methods： Using “medical groups” or “medical community” and “medical insurance payment methods” or “payment methods reform” as keywords， search for research related to the medical insurance payment reform conducted by Chinese medical groups in the CNKI， Wanfang， VIP and Pubmed databases. The retrieval time is from the establishment of each database to March 2020. Using the method of comparative study， this paper evaluates the fund operation， cost control， fund compensation level， medical flow direction， medical economic burden and medical satisfaction， summarizes the measures and achievements of medical insurance payment reform carried out by the medical groups， and analyzes the existing problems. Results： After the medical groups carried out the reform of the medical insurance payment methods， the treatment rate of patients in the county has been improved， the medical insurance fund in the county had a surplus， medical expenses were effectively controlled， residents′ out-of-pocket medical expenses were reduced， and the satisfaction rate increased. Conclusion： The reform of the medical insurance payment methods promote the construction of the medical groups， but there are still some problems， such as the imperfect profit distribution mechanism in medical groups， the deviation in the determination of global budget limit， the ineffective fee control of global budget and the backward information construction， etc. Therefore， it is necessary to allocate the balance fund reasonably， promote the formation of a community of interests， formulate the global budget scientifically， implement the multiple and compound payment methods， strengthen the informatization construction of medical groups， and promote the application of big data technology.

Key words: font-size:medium, ">Medical Groups； Medical Community； Medical Insurance Payment； Payment Methods Reform；Systematic Review