法国医疗保健概述

法国的医疗体系建立在双层医疗保险体系的基础上.

The healthcare spend is predominantly funded by mandatory public health insurance (57%) and voluntary private health insurance (26%), 其余部分来自其他州税(10%)和患者自付费用(7%)。[1].

All residents are required to pay approximately 8% of their salary into the statutory health insurance scheme (SHI), 由社会保障机构管理 la安全炸药 Sociale. Approximately 90% of the population also has additional (voluntary) private health insurance (from for-profit or not-for-profit companies) to cover the gap between point-of-use healthcare costs and the amount reimbursed by public health insurance.

卫生保健由卫生和预防部集中管理, 哪一个在组织卫生系统和确定运行条件方面起着重要作用. The central government sets the healthcare budget and controls the amount and direction of healthcare expenditure via la安全炸药 Sociale.

地方一级的保健服务由18个地区卫生机构管理。. Each ARS has a strategic health plan to allocate their healthcare budget to services that meet the needs of their population. In 2019, the largest category of healthcare spending was inpatient care in public and private hospitals (32%) and outpatient care in 主要的 care centres, 专科服务及牙科护理(28%)[1]. 区域医院联盟成立了区域医院集团(领土医院团 - GHT)在其区域内整合公共卫生服务.

法国卫生系统的特点是自由选择病人. GP referrals are the gateway to 专家 care and patients (or their GP) can choose to refer to a public or private 专家. 

ARS’ play an important role in the availability and distribution of public and private services in their region through allocation of authorisations. ARS have a dual role as the local approval authority and regulator as well as managing the public hospitals. Delivery of any new clinical services and equipment (in hospitals and some outpatient services) must first be authorised by the ARS.  Authorisations are limited to enable the ARS to control the volume of clinical services offered in their region.

The National Authority for Health (HAS - Haute Autorité de Santé) accredits doctors to practice and independently certifies public and private hospitals against national clinical quality and safety criteria.

每年, la s curit Sociale决定药品的国家固定费用, 主要的, 专家, 住院和牙科护理.

Most healthcare services in 法国 are reimbursed on a fee-for-service basis based on Diagnosis Related Group (DRG), 然而，这种情况正在开始改变.

公立和私立医疗机构都是按服务收费的, 诊断计算, 程序或服务. Patients accessing health services are reimbursed by their public health insurance fund between 80-100% of that national fee, 无论他们是从公共提供商还是私有提供商访问服务. 然而，私人医生可能会向患者收取高于国家规定费率的费用. 因此，人口的很大一部分(约为. 90%)有额外的私人健康保险来弥补任何缺口.

根据医生收取的服务费用，他们被分为三个类别. Sector 1 doctors charge the national fixed fee and the patient will be reimbursed 80-100% of that fee each time they access the service.  大多数全科医生都属于这一类. 第二部门的医生被批准以“理由”收取更高的费用. Patients are reimbursed 80-100% of the national fixed fee and pay the gap using private health insurance or a self-funded co-payment. 大多数专家都属于这一类. 第三区医生没有收费限制. 他们通常是在高度专业化的医学领域执业的医生.

Hospital fees (public and private) are set by the central government at a fixed rate per patient (based on DRG) to cover the fixed costs of clinical facilities, 政府, 护理及酒店服务. Public hospitals are also paid per patient (by DRG) but at a rate 20% higher than the private hospitals. Public hospitals also receive additional dedicated funds for activities not directly related to individual health service delivery, 比如研究和培训.

Private hospitals charge patients an additional fee if they choose to access a private room or extra hotel services, 这通常由患者的私人健康保险或自费支付. Private hospitals will also receive additional income from 专家s who pay the hospital for use of their facilities (ie. 剧院、咨询室)和提供行政服务. This is a negotiated rate and based on a percentage of the 专家’s income and the level of additional services they access from the hospital (such as consultation rooms, 行政支持等.).

心理健康

The national government has introduced a value-based model in which healthcare providers are reimbursed based on the value they provide to patients, 而不是他们提供的服务数量.

心理健康 services (from 2022) and Rehabilitation services (from 2023) are funded using a tiered fee structure based on day-rate, population allocation (based on socio-economic status and patient acuity within that region) and quality outcomes (reported patient clinical outcomes and experience). 

医疗保健服务提供者

Specialist consultants in 法国 are either self-employed and consult at the private hospitals or work in the public system. 他们很少同时兼顾, 尽管许多自雇专家可能为许多不同的私人供应商工作. 病人需要全科医生的转诊才能获得专科服务. 

在Ramsay sant设施工作的大多数专家都是自雇人士, 除了康复医生和一些精神病医生. Self-employed 专家s are paid directly by the government or by the patient (who will be reimbursed). Specialists must be authorised to practice at each 全国网赌正规平台桑特 hospital by the hospital clinical 政府. 

[1] 经合组织在欧盟国家健康概况中的健康状况-法国，2021年

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The information in the ‘全国网赌正规平台的市场’ section of the Ramsay Group’s website is based on information obtained from external sources and is current as at 16 February 2023. Ramsay尚未独立核实本节中提供的信息. 这些信息是摘要形式的，并不一定是完整的.

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