[1]邱英鹏赵羽西赵翔肖月.澳大利亚假体类高值医用耗材医保准入管理经验及启示[J].中国卫生质量管理,2021,28(05):012-15.[doi:10.13912/j.cnki.chqm.2021.28.5.04 ]
　QIU Yingpeng,ZHAO Yuxi,ZHAO Xiang.Experience in Medical Insurance Access Management of Prosthetic High Value Medical Consumables in Australia and Its Implications[J].Chinese Health Quality Management,2021,28(05):012-15.[doi:10.13912/j.cnki.chqm.2021.28.5.04 ]
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澳大利亚假体类高值医用耗材医保准入管理经验及启示
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第28卷
期数:
2021年05期
页码:
012-15
栏目:
特别关注
出版日期:
2021-05-28

文章信息/Info

Title:
Experience in Medical Insurance Access Management of Prosthetic High Value Medical Consumables in Australia and Its Implications
作者:
邱英鹏赵羽西赵翔肖月
国家卫生健康委卫生发展研究中心
Author(s):
QIU Yingpeng; ZHAO Yuxi; ZHAO Xiang
China National Health Development Research Center
关键词:
澳大利亚; 假体类; 高值医用耗材; 医保准入; 卫生技术评估
Keywords:
Australia; Prostheses; High Value Medical Consumables;  Medical Insurance Access; Health Technology Assessment
分类号:
R197.39;TH77
DOI:
10.13912/j.cnki.chqm.2021.28.5.04
文献标志码:
A
摘要:
目的分析澳大利亚假体类高值医用耗材医保准入管理经验，为我国医保部门建立相关机制提供参考。方法访问澳大利亚卫生部官方网站，检索《假体类医用耗材目录》管理相关政策、文件和指南，并进行信息提取。结果澳大利亚《假体类医用耗材目录》管理包括申报材料及证据提交、评估、评审及决策四大步骤。在基于综合价值判断进行准入和支付政策制定过程中，卫生技术评估（HTA）提供了重要的循证证据。结论我国医保部门可参考澳大利亚高值医用耗材管理经验，建立以价值为基础，以卫生技术评估为支持，经第三方委员会独立评审的高值医用耗材准入机制。
Abstract:
ObjectiveTo analyze the medical insurance access management experience of high value medical consumables for prostheses in Australia, and to provide reference for the establishment of relevant mechanism for medical insurance departments in China.MethodsBy visiting the official website of the Australian Ministry of Health, the relevant policies, documents and guidelines for management of Prosthetic Medical Consumables List were retrieved and the information was extracted.ResultsThe management of Australian Prosthetic Medical Consumables List included four steps: submission of application materials and evidence, evaluation, review and decision.Health technology assessment (HTA) provided important evidence-based evidence in the development of access and payment policies based on comprehensive value judgments.Conclusion The medical insurance department in China can refer to the management experience of high value medical consumables in Australia, and establish the access system of high value medical consumables which is based on value and supported by HTA and independently reviewed by the third-party committee.

参考文献/References:

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更新日期/Last Update: 2021-05-28