«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:

42

期数:

2025年01期

页码:

61-64

栏目:

成本与费用

出版日期:

2025-01-07

文章信息/Info

Title:

Study on Impact of DRG Payment Mode Reform on the Medical Expense Burden of Hospitalized Patients

作者:

司小平¹

1.常州市第一人民医院，江苏 常州 213003

Author(s):

SI Xiaoping

The First People's Hospital of Changzhou, Jiangsu Changzhou 213003, China

关键词:

DRG支付; 医疗费用负担; 双重差分模型

Keywords:

DRG payment;  medical expense burden;  double difference model

分类号:

R197

文献标志码:

A

摘要:

目的：分析DRG支付对住院患者医疗费用负担的影响，助力我国医保支付方式的深化改革。方法：以2020—2022年江苏省常州市30家医院的医保住院患者为样本，采用双重差分模型，实证分析DRG支付前后住院患者医疗费用负担的差异。结果：实行DRG支付后，试点医院住院患者的医疗费用总额和个人账户自付金额分别下降了12.1%和11.2%；耗材费和药品费分别下降了17.1%和18.9%；城镇职工医保患者的医疗费用负担低于城乡居民医保患者，年龄越大的患者医疗费用负担越重；三级医院的降费减负效应强于二级及以下医院。结论：DRG支付具有显著的降费减负效应，其作用的着力点是降低了耗材费和药品费；在遵循我国医改顶层设计的基础上，应加快推进DRG支付方式改革，根据医院等级分层次探索匹配的DRG支付方式，同时关注患者的个体特征。

Abstract:

Objective To analyze the impact of DRG payment on the medical expense of hospitalized patients, and to help deepen the reform of health insurance payment method in China. Methods Taking the medical insurance inpatients of 30 hospitals in Changzhou City Jiangsu Province as samples from 2020-2022, the double difference model was used to analyze the difference in medical expense burden of hospitalized patients before and after DRG payment reform. Results After DRG payment reform, the total medical cost and out-of-pocket amount of individual account of inpatients in the pilot hospitals decreased by 12.1% and 11.2%, respectively, and the consumables expense and drugs expense decreased by 17.1% and 18.9%, respectively. The medical expense burden of urban employee insured patients was lower than that of urban and rural resident insured patients, and the older the patients, the heavier the medical expense burden. The effect of expense reduction and burden reduction of tertiary hospitals was stronger than that of secondary and lower hospitals. Conclusion DRG payment mode has significant expense reduction and burden reduction effect. The key-point of its function is to significantly reduce the consumables expense and drugs expense. On the basis of following the top-level design framework of healthcare reform in China, the government should accelerate the implementation of DRG payment reform, explore the reform of matching DRG payment methods based on hospital levels, and pay attention to individual characteristics of patients.

常用功能

更新日期/Last Update: 2025-01-07