[1]李锦渊,彭美华,郑 丹,等.广安市DRG点数法改革成效与策略研究[J].卫生经济研究,2023,40(10):70-73.
　LI Jinyuan,PENG Meihua,ZHENG Dan,et al.Study on the Effectiveness and Strategies of DRG Scoring Method Reform[J].Journal Press of Health Economics Research,2023,40(10):70-73.
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广安市DRG点数法改革成效与策略研究

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
40
期数:
2023年10期
页码:
70-73
栏目:
筹资与支付
出版日期:
2023-09-28

文章信息/Info

Title:
Study on the Effectiveness and Strategies of DRG Scoring Method Reform
作者:
李锦渊1; 彭美华1; 郑 丹2; 何 丹2; 李 希1; 廖 芳1
1.成都中医药大学管理学院，四川 成都 611137
2.四川省广安市医疗保障局，四川 广安 638500
Author(s):
LI Jinyuan;  PENG Meihua;  ZHENG Dan;  HE Dan;  LI Xi;  LIAO Fang
School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu Sichuan 611137, China
关键词:
医保支付方式; DRG点数法; 医疗机构; 广安市
Keywords:
medical insurance payment method;  DRG scoring method;  medical institutions;  Guang'an City
分类号:
F840.684
文献标志码:
B
摘要:
目的：总结四川省广安市DRG点数法改革实践经验与成效，提出政策建议。方法：将18家试点医疗机构住院病例结算数据分为四个时间阶段，从服务能力、费用控制、服务效率和质量安全四个维度对DRG点数法改革运行情况进行分析。结果：实行DRG点数法改革后，医疗机构服务能力增强，控费减负效果明显，服务质量未发生明显变化。建议：完善医保协商谈判机制，优化病例分组，丰富差异系数参数，完善监管体系，构建多元医保支付方式。
Abstract:
Objective To summarize the practical experience and effectiveness of reform DRG scoring method reform in Guang'an, Sichuan province, and to put forward countermeasures and suggestions. Methods The settlement data of inpatient cases in 18 pilot medical institutions were divided into four time stages. The operation of DRG scoring method reform was analyzed from four dimensions of service capacity, cost control, service efficiency, and quality safety. Results After the implementation of the DRG scoring method reform, the service capacity of medical institutions has been enhanced, the effect of cost control and burden reduction has been significant, and there has been no significant change in service quality. Conclusion It is recommended to improve the negotiation mechanism for medical insurance, optimize case grouping, enrich the coefficient of difference parameters, improve the supervision system, and build a diversified medical insurance payment method.

参考文献/References:

[1] 刘敬，陈运山，顾雪非，等.DIP付费改革对医疗机构经济运行的影响研究——以广州市某三甲医院为例[J].卫生经济研究，2022，39（12）：29-33.
[2] 何瑜璇.北京CHS-DRG支付方式改革实际运行状况分析——以东城区5家医院为例[J].中国医疗保险，2022（11）：71-76.
[3] 熊蔓，伍林生.重庆市DRG实施成效评估及问题分析——基于模拟运行阶段[J].卫生经济研究，2022，39（7）：28-31.

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更新日期/Last Update: 2023-09-28