[1]廖藏宜,秦纪华,蓝志成.中医优势病种按疗效价值付费的柳州经验[J].卫生经济研究,2023,40(6):61-63,67.
　LIAO Zangyi,QIN Jihua,LAN Zhicheng.Experience of Efficacy Value Payment for Dominant Diseases of Traditional Chinese Medicine in Liuzhou[J].Journal Press of Health Economics Research,2023,40(6):61-63,67.
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中医优势病种按疗效价值付费的柳州经验
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
40
期数:
2023年6期
页码:
61-63,67
栏目:
中医药管理
出版日期:
2023-06-05

文章信息/Info

Title:
Experience of Efficacy Value Payment for Dominant Diseases of Traditional Chinese Medicine in Liuzhou
作者:
廖藏宜1; 秦纪华1; 蓝志成2
1.中国政法大学，北京 102249
2.广西壮族自治区柳州市医疗保障事业管理中心，广西 柳州 545000
Author(s):
LIAO Zangyi;  QIN Jihua;  LAN Zhicheng
China University of Political Science and Law, Beijing 102249, China
关键词:
中医药服务; 中医优势病种; 按疗效价值付费; 柳州
Keywords:
traditional Chinese medicine services;  dominant diseases of traditional Chinese medicine;  efficacy value payment;  Liuzhou
分类号:
R19
文献标志码:
B
摘要:
医保DRG/DIP支付背景下，柳州市积极探索符合中医药服务特点的定价和补偿机制，对中医优势病种实施按疗效价值付费，取得了显著的社会效益和经济效益。柳州市改革经验主要有：建立中医病种准入医保目录的遴选程序和可兼容DRG付费的医保支付基准；明确基于疗效价值的临床路径、疗效考评指标，确保中西医同病同效同价支付，解决了中医难以融入现行医保支付体系的难题；发挥医保“约束-引导-激励”机制优势，实现了医患保三方共赢。
Abstract:
Under the background of DRG/DIP payment, Liuzhou actively explores pricing and compensation mechanisms that conform to the characteristics of traditional Chinese medicine services, and implements payment based on efficacy value for dominant diseases of traditional Chinese medicine. The reform has achieved significant social and economic benefits. The reform experience of Liuzhou mainly includes: establishing a selection process for the admission of traditional Chinese medicine diseases to the medical insurance catalogue and a medical insurance payment benchmark that is compatible with DRG payment; Clarifying the clinical pathway and evaluation indicators based on efficacy value to ensure the same disease, same effect, and same price of traditional Chinese and Western medicine, and solve the problem of traditional Chinese medicine difficult to integrate into the current medical insurance payment system; Relying on the "constraint-guidance-incentive" mechanism of medical insurance to achieve a win-win situation among hospitals, patients, and medical insurance.

参考文献/References:

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更新日期/Last Update: 2023-06-05