[1]李锦渊,彭美华,杨 松,等.临床医生对DRG改革的知信行调查[J].卫生经济研究,2023,40(8):86-90.
　LI Jinyuan,PENG Meihua,YANG Song,et al.Investigation of Knowledge-attitude-practice about DRG Payment Reform among Clinicians[J].Journal Press of Health Economics Research,2023,40(8):86-90.
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临床医生对DRG改革的知信行调查
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
40
期数:
2023年8期
页码:
86-90
栏目:
医院管理
出版日期:
2023-07-26

文章信息/Info

Title:
Investigation of Knowledge-attitude-practice about DRG Payment Reform among Clinicians
作者:
李锦渊1; 彭美华1; 杨 松2; 朱旭林1; 吴靖文3; 余丽娟3; 周小林4; 王 阳4
1.成都中医药大学管理学院，四川 成都 611137
2.成都市三六三医院，四川 成都 610041
3.四川省眉山市医疗保障局，四川 眉山 620020
4.上海金仕达卫宁软件科技有限公司，上海 200040
Author(s):
LI Jinyuan;  PENG Meihua;  YANG Song;  ZHU Xulin;  WU Jingwen;  YU Lijuan;  ZHOU Xiaolin;  WANG Yang
School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu Sichuan 611137, China
关键词:
临床医生; DRG改革; 知信行
Keywords:
clinicians;  DRG payment reform;  knowledge-attitude-practice
分类号:
R19
文献标志码:
A
摘要:
基于临床医生的视角，通过政策认知、价值认同、行为预判三个维度，开展临床医生对DRG改革的知信行调查，探究DRG改革存在的问题。结果显示：临床医生对DRG改革的政策认知度较好，但政策理解不充分；改革认同度较高，但参与不积极；政策工具为新技术发展提供保障，但推诿重症依然存在。建议：加大培训力度，帮助临床医生适应DRG改革；提高临床医生的改革参与度，规范诊疗行为；发挥医界社会组织的作用，促进医患共享决策，推动DRG改革平稳运行。
Abstract:
Based on the perspective of clinicians, this article conducts a knowledge-attitude-practice survey of DRG payment reform among the clinicians through three dimensions including policy awareness, value recognition, and behavior prediction, and explores the problems in DRG payment reform. The results show that the clinicians have a good awareness of DRG reform policies, but their understanding of the policies is not sufficient. The clinicians have a high degree of recognition for the reform, but their participation is not active. Policy tools provide protection for the development of new technologies, but shifting blame for severe cases still exists. Therefore, it is necessary to strengthen training to help clinicians adapt to DRG payment reform, improve the participation of clinicians in the reform and standardize their diagnosis and treatment behavior, give full play to the role of medical social organizations, promote shared decision-making between clinicians and patients, and advance smooth operation of DRG payment reform.

参考文献/References:

[1] 国家医疗保障DRG分组与付费技术规范[EB/OL].[2019-10-16].http://www.nhsa.gov.cn/art/2019/10/24/art_37_1878.html.
[2] Charlson M E,Sax F L,Mackenzie C R,et al.Morbidity during hospitalization:Can we predict it[J].J Chronic Dis,1987,40(7):705-712.
[3] Anderson G,Ikegami N.How can Japan's DPC inpatient hospital payment system be strengthened?Lessons from the U.S.Medicare Prospective System[M].Washington,DC:Health and Global Policy Institute,Centrefor Strategic and International Studies,2011.
[4] Bae K.10-year Experience of DRG Payment in Korea[M].2012.
[5] Kwon S.DRG-based Payment System in Korea:Key Isues and Challenges[M].Seoul:Health Insurance and Review and Assess－ment Service,2012. [6] 俞卫.DRG适合三甲医院DIP在二三线城市更有优势[J].中国卫生，2021（2）：84-86.
[7] 田昕，梁丽，辛有清.公立医院付费制度改革对医疗质量管理的影响探讨[J].中国医院管理，2015，35（5）：4-6.
[8] 张萌萌，胡牧.DRGs在北京医保支付管理中的应用[J].中国医疗保险，2015，4：51-53.
[9] 曾俊群，王茹，刘帆.北京某三级甲等医院试点BJ-DRGs付费的收支分析[J].中华医院管理杂志，2014，30（7）：502-505.
[10] 郭建国，许斯略，余佳莹，等.DRG付费下特殊病例解决路径的眉山实践[J].中国医疗保险，2021，2：55-59.
[11] Quantin C,Sauleau E,Bolard P,et al.Modeling of high -cost patient distribution within renal failure diagnosis related group[J].J Clin Epi-demiol,1999,52(3):251-258.
[12] Georgescu I,Hartmann F G H.Sources of financial pres-sure and up coding behavior in French public hospitals[J].Health Policy,2013,110(2-3):156-163.
[13] Roh C Y.Medical innovation and socialexternality[J].Open Innov Technol Mark Complex,2017,3:3.
[14] Schiergens T S,Sienel W G R,Werner J.Implementierung neuer Technologien unter?konomischen Gesichtspunkten im DRG-System[J].Chirurg,2020,91(7):561-566.
[15] Scheller-Kreinsen D, Quentin W,Busse R.DRG-based hospital payment systems and technological innovation in 12 European countries[J].Value Health,2011,14(8):1166-1172.
[16] 顾昕，惠文，沈永东.社会治理与医保支付改革：理论分析与国际经验[J].保险研究，2022（2）：99-115.

相似文献/References:

[1]杨 松,钟艳红,王 绪,等.DRG背景下医疗服务行为规范影响因素分析——基于结构方程模型[J].卫生经济研究,2023,40(7):50.
　YANG Song,ZHONG Yanhong,WANG Xu,et al.Study on the Influencing Factors of Medical Service Behavior Norms in the Context of DRG Payment ——Based on Structural Equation Model[J].Journal Press of Health Economics Research,2023,40(8):50.

更新日期/Last Update: 2023-07-26