[1]李 浩,陶红兵.DRG付费下医方低码高编行为界定与潜在风险研究[J].卫生经济研究,2022,39(4):28-32.
　LI Hao,TAO Hong-bing.Research on the Judgement and Potential Risks of Upcoding in the Context of DRG Payment[J].Journal Press of Health Economics Research,2022,39(4):28-32.
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DRG付费下医方低码高编行为界定与潜在风险研究
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
39
期数:
2022年4期
页码:
28-32
栏目:
专题
出版日期:
2022-03-28

文章信息/Info

Title:
Research on the Judgement and Potential Risks of Upcoding in the Context of DRG Payment
作者:
李 浩1; 陶红兵1
1.华中科技大学同济医学院医药卫生管理学院，湖北 武汉430030
Author(s):
LI Hao;  TAO Hong-bing
School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan Hubei 430030, China
关键词:
疾病诊断相关分组; 低码高编; 道德风险; 诊疗行为; 信息不对称
Keywords:
diagnosis related groups;  upcoding;  moral hazard;  medical behavior;  information asymmetry
分类号:
R19
文献标志码:
A
摘要:
医方低码高编行为是各国开展DRG付费面临的棘手问题，也是我国在探索DRG付费道路上面临的巨大挑战。本文对低码高编问题进行梳理，并结合国外DRG付费现状，总结低码高编行为的潜在风险，以期提高医、患、保三方对低码高编行为的认识，并引起重视。
Abstract:
The upcoding behavior is a thorny problem faced by countries in developing DRG payment, and it is also a huge challenge faced by China. This paper sorted out the problem of upcoding and had an insight into the current situation of DRG payment in foreign countries. By summarizing the potential risks of upcoding, this study tried to raise the awareness of upcoding among medical providers, patients, and medical insurance.

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更新日期/Last Update: 2022-03-28