[1]谭华伟,张培林,皮 星,等.医疗服务成本支撑支付价格形成的现实困境与实践路径[J].卫生经济研究,2021,38(10):8-13.
　TAN Hua-wei,ZHANG Pei-lin,PI Xing,et al.The Realistic Dilemma and Practical Path of Formation of Payment Price Supported by Medical Service Cost[J].Journal Press of Health Economics Research,2021,38(10):8-13.
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医疗服务成本支撑支付价格形成的现实困境与实践路径

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
38
期数:
2021年10期
页码:
8-13
栏目:
本刊特稿
出版日期:
2021-09-26

文章信息/Info

Title:
The Realistic Dilemma and Practical Path of Formation of Payment Price Supported by Medical Service Cost
作者:
谭华伟1; 张培林1; 皮 星1; 程 伟1; 张 云1; 彭 琳1; 王彩云2; 林 子3; 陈 菲4; 放雄鹰4
1.重庆市医院成本管理研究中心，重庆 400700
2.重庆市红十字会医院（江北区人民医院），重庆 400020
3.重庆市卫生服务中心，重庆400020
4.重庆医科大学公共卫生与管理学院，重庆 400016
Author(s):
TAN Hua-wei;  ZHANG Pei-lin;  PI Xing;  CHENG Wei;  ZHANG Yun;  PENG Lin;  WANG Cai-yun;  LIN Zi;  CHEN Fei;  FANG Xiong-ying
Chongqing Hospital Cost Management Research Center，Chongqing 400700, China
关键词:
医疗服务价格; 医疗服务成本; 价格形成机制
Keywords:
medical service price;  medical service cost;  price formation mechanism
分类号:
R19
文献标志码:
A
摘要:
基于医疗服务价格形成碎片化和成本虚化等关键问题，以成本、价格与支付要素整合和功能协同为导向，从医疗服务价格决定机制和形成机制入手，分析比较了英国、美国、澳大利亚、法国医疗服务成本支撑价格形成的内在机理。结合中国实际，构建了“政府主导-成本核算-参考成本-基准价格-支付价格”的医疗服务价格形成框架，并从医院成本信息一体化、人力价值评估量化标准、强化政府预算硬约束、医保目录动态调整四个方面提出完善医疗服务成本支撑价格形成的长效机制。
Abstract:
Based on the key issues such as fragmentation and virtual cost of medical services, and guided by the integration and functional coordination of cost, price and payment elements, starting with the price determination mechanism and formation mechanism of medical services, this paper analyzes and compares the internal mechanism of the formation on payment price supported by medical service cost in Britain, the United States, Australia and France. Combined with the reality of China, this paper constructs a medical service price formation framework of "government leading-cost accounting-reference cost-basis price-payment price". It also puts forward a long-term mechanism to improve the formation of payment price supported by medical service cost from four aspects: the integration of hospital cost information, the quantitative standard of human value evaluation, the strengthening of the hard constraint of government budget and the dynamic adjustment of medical insurance catalogue.

参考文献/References:

[1] Arrow KJ.Uncertainty and the Welfare Economics of Medical Care[J].The American Economic Review,1963，53(5):941-973.
[2] 张培林，颜维华，谭华伟，等.重庆市医疗服务价格动态调整的现实困境和推进路径研究[J].卫生经济研究，2019（10）：25-29.
[3] World Health Organization. Price setting and price regulation in health care Lessons for advancing Universal Health Coverage[M]. Geneva:World Health Organization, 2019.
[4] 郭科，顾昕.过度医疗的解决之道:管制价格、强化竞争还是改革付费? [J].广东社会科学，2017（5）：176-185.
[5] Berenson RA,Upadhyay DK, Delbanco S,et al.A Typology of Payment Methods[R].Urban Institute and the Catalyst for Payment Reform，2016.
[6] Reinhardt UE.The many different prices paid to providers and the flawed theory of cost shifting: is it time for a more rational all-payer system? [J].Health Affairs，2011,30(11):2125-2133.
[7] Murray R,Berenson RA.Hospital Rate Setting Revisited. Dumb Price Fixing or a Smart Solution to Provider Pricing Power and Delivery Reform? [R].The Urban Institute，2015.
[8] Independent Hospital Pricing Authority.National Efficient Cost Determination 2020-21[R].Australia: Commonwealth of Australia,2020.
[9] Independent Hospital Pricing Authority.National efficient price determination2020-21[R].Australia: Commonwealth of Australia,2020.
[10] National Health Service.Step-by-Step Guide:Calculating the 2013-14 National Tariff[R].England, 2013.
[11] NHS England,NHS Improvement.2019/20 National Tariff Payment System[R].England,2019.
[12] Reinhard B,Alexander G,Wilm Q,et al.Diagnosis-related groups in Europe:moving towards transparency,efficiency and quality in hospitals[M].New York, 2011.
[13] Martine Bellanger,Zeynep Or,Valérie Paris,et al.Approaches for Cost Assessment & Price Setting in Practice[R].Health BASKET, 2005.
[14] 王洛忠，杨济溶.地方政府医药价格改革的时空演进机理:以政策创新扩散为视角[J].北京行政学院学报，2020（1）：1-13.
[15] 施文凯，吕兰婷.基本医疗保险循证决策体系构建:卫生技术评估的作用[J].中国卫生政策研究，2019（11）：73-79.

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更新日期/Last Update: 2021-09-26