[1]王淑蓉,陈 洁,阮寅珊,等.DRG支付改革下县域医共体的经济运行分析[J].卫生经济研究,2024,41(12):12-15.
　WANG Shurong,CHEN Jie,RUAN Yinshan,et al.Analysis of the Impact of DRG Payment Reform on the Economic Operation of County-level Medical Communities[J].Journal Press of Health Economics Research,2024,41(12):12-15.
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DRG支付改革下县域医共体的经济运行分析
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
41
期数:
2024年12期
页码:
12-15
栏目:
改革探索
出版日期:
2024-12-03

文章信息/Info

Title:
Analysis of the Impact of DRG Payment Reform on the Economic Operation of County-level Medical Communities
作者:
王淑蓉1; 陈 洁2; 阮寅珊3; 孙统达1
1.宁波卫生职业技术学院，浙江 宁波 315100
2.余姚市人民医院，浙江 余姚 315400
3.余姚市卫生健康局，浙江 余姚 315400
Author(s):
WANG Shurong;  CHEN Jie;  RUAN Yinshan;  SUN Tongda
Ningbo College of Health Sciences, Ningbo Zhejiang 315100, China
关键词:
县域医共体; DRG; 经济运行
Keywords:
county-level medical community;  DRG;  economic operation
分类号:
R19
文献标志码:
A
摘要:
目的：分析DRG支付改革后县域医共体的经济运行变化，为完善相关政策提供实证参考。方法：以某市4个县域医共体为研究对象，收集牵头医院及分院2019—2022年的经济运行、费用水平、服务效率等数据，进行改革前后的对比分析。结果：DRG支付改革后，医共体牵头医院和分院的总收入分别增长了15.67%和30.08%，医疗收入分别增长了7.10%和2.66%，但住院收入分别下降了0.04%和39.21%；除去财政补助收入后，总收支结余为负；均次费用明显增长，服务总量和服务效率出现下降趋势；病例数前十的病组中有3个病组出现亏损。结论：DRG支付改革下，县域医共体应进一步完善医保监管体系，规范诊疗行为；加强精细化全成本管理，有效控制医疗亏损；推进医疗服务价格动态调整，有效控制患者费用；强化医共体协同和分级诊疗，提升分院诊疗技能和服务效率。
Abstract:
Objective To explore the impact of Diagnosis-Related Group (DRG) payment reform on the economic operation of county-level medical communities, and to provide empirical references for the improvement of related policies. Methods Taking four county-level medical communities in a city as the study objects, the data on the economic operation, cost level, and service efficiency of the lead hospitals and branch hospitals from 2019 to 2022 were collected, and the data were compared and analyzed before and after the reform. Results After the DRG payment reform, the total revenues of the lead hospitals and branch hospitals of the medical communities increased by 15.67% and 30.08%, respectively, and medical revenues increased by 7.10% and 2.66%, respectively, but inpatient revenues declined by 0.04% and 39.21%, respectively. After removing the income from the financial subsidy, the total balance of income and expenditure was negative. The average per-visit costs increased significantly, and the total number of services and the efficiency of the services showed a declining trend. Three out of the top ten disease groups with the highest number of cases experienced losses. Conclusion Under the DRG payment reform, county-level medical communities should further improve the medical insurance supervision system to standardize the diagnosis and treatment behaviors, strengthen the refined full-cost management to effectively control the medical losses, promote the dynamic adjustment of medical service prices to effectively control the patient's costs, and strengthen the collaboration of the medical communities and hierarchical diagnosis and treatment to improve the diagnosis and treatment skills and service efficiency of the branch hospitals.

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更新日期/Last Update: 2024-12-03