[1]岳铭坤,李 凯,黄 娜,等.按病种付费对中医优势病种住院费用的影响研究 ——基于PSM-DID法[J].卫生经济研究,2024,41(03):62-64.
　YUE Mingkun,LI Kai,HUANG Na,et al.Study the Impact of DRG on the Hospitalization Expenses of the Dominant Diseases of Traditional Chinese Medicine ——Based on PSM-DID Method[J].Journal Press of Health Economics Research,2024,41(03):62-64.
点击复制

按病种付费对中医优势病种住院费用的影响研究
——基于PSM-DID法
分享到：

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
41
期数:
2024年03期
页码:
62-64
栏目:
成本与费用
出版日期:
2024-02-28

文章信息/Info

Title:
Study the Impact of DRG on the Hospitalization Expenses of the Dominant Diseases of Traditional Chinese Medicine
——Based on PSM-DID Method
作者:
岳铭坤1; 李 凯1; 黄 娜2; 李青峰2; 杨土保2; 周良荣1
1.湖南中医药大学人文与管理学院，湖南 长沙 410208 2.中南大学湘雅公共卫生学院，湖南 长沙 410078
Author(s):
YUE Mingkun;  LI Kai;  HUANG Na;  LI Qingfeng;  YANG Tubao;  ZHOU Liangrong
FirstSchool of Humanities and Management, Hunan University of Chinese Medicine, Changsha Hunan 410208, China
关键词:
按病种付费; 中医优势病种; 住院费用; 双重差分; 倾向得分匹配法
Keywords:
DRG;  dominant diseases of traditional Chinese medicine;  hospitalization expenses;  double difference;  propensity score matching method
分类号:
R197
文献标志码:
A
摘要:
目的：分析按病种付费对中医优势病种住院费用的影响，为中医按病种付费改革提供参考。方法：采用某中医医院实施按病种付费的高位肛瘘患者住院费用数据，经倾向得分匹配法（PSM）匹配后，进行双重差分（DID）回归分析，探讨按病种付费对中医优势病种住院费用的影响。结果：实施按病种付费后，高位肛瘘患者住院总费用下降了1 067.63元、自付费用下降了656.66元、住院天数缩短了5.54天、西药费增长了406.55元、中成药费下降了126.80元。结论：在中医优势病种按病种付费过程中，应加强医保监督，持续完善、更新中医信息系统，扩大按病种付费的中医优势病种范围，突出中医临床路径优势，促进中医药传承创新发展。
Abstract:
Objective To analyze the impact of DRG on the hospitalization expenses of the dominant diseases of traditional Chinese medicine, and to provide reference for the reform of DRG in traditional Chinese medicine. Methods The hospitalization expenses data of high anal fistula patients in a pilot traditional Chinese medicine hospital that implemented DRG were collected. After propensity score matching(PSM), double difference(DID) regression analysis was used to explore the impact of DRG on the hospitalization expenses of the dominant diseases of traditional Chinese medicine. Results After the implementation of DRG, the total hospitalization expenses of patients with high anal fistula decreased by 1 067.63 yuan, the out-of-pocket expenses decreased by 656.66 yuan, the number of hospitalization days was shortened by 5.54 days, the cost of western medicines increased by 406.55 yuan, and the cost of Chinese patent medicines decreased by 126.80 yuan. Conclusion In the process of DRG for the dominant diseases of traditional Chinese medicine, it is necessary to strengthen medical insurance supervision, continuously improve and update Chinese medicine information system, expand the scope of the dominant diseases of traditional Chinese medicine with DRG, emphasize the advantages of the clinical pathway in traditional Chinese medicine, and promote the inheritance, innovation, and development of traditional Chinese medicine.

参考文献/References:

[1] 杨辰毓妍，范少萍，蔡荣，等.医学领域学科交叉性和论文影响关系及其测度模型构建研究[J].中华医学图书情报杂志，2020，29（11）：24-30.
[2] 沈敏学，胡明，曾娜，等.双重差分模型在医学研究中的应用[J].中国卫生统计，2015，32（03）：528-531.
[3] 吴学智，李捷，邓淑娟，等.基于PSM-DID 法探讨DRGs付费对胆结石患者住院费用的影响[J].中国卫生统计，2022，39（03）：432-434.
[4] 潘莉.基于临床路径的单病种付费机制研究——以山东省某医院为例[J].中国医疗保险，2018（07）：46-49.
[5] 袁洛琪，何庆红，秦雪征.医保支付方式改革与医疗服务——来自四川省A市医保总额控制的证据[J].保险研究，2022（07）：96-113.
[6] 史芳，苏东海，盛馨源，等.基于现代医院管理制度的三级医院院按病种付费的实施效果分析[J].智慧健康，2022，8（34）：22-26，51.
[7] 曹乔，谭婧，王雯，等.成都市单病种定额付费实施效果分析:基于双重差分模型[J]. 中国循证医学杂志，2018，18（08）：807-811.
[8] 陈晨，臧文斌，赵绍阳.医保预付制改革对医院行为和医疗费用的影响研究——基于单病种定额付费的改革[J].经济评论，2023（03）：133-151.
[9] 朱小颖，田侃，方鹏骞，等.我国中医医院DRG付费若干问题与对策探讨[J].中国医院，2022，26（05）：10-12.
[10] 胡玥.中医优势病种按病种付费标准研究[D].武汉：华中科技大学，2022.
[11] 山东省医保局.动态调整我省按病种收费的中医优势病种数量达20个[EB/OL].（2022-10-27）.[2023-07-09].https://baijiahao.baidu.
com/s?id=1747827589982535317&wfr=spider&for=pc. [12] 福建省医保局.福建42个中医病种实施按病种收付费[EB/OL].（2020-11-19）.[2023-07-09].http://m.xinhuanet.com/fj/2020-11/19/c_1126758565.htm.

相似文献/References:

[1]尹红燕,王 珩,李念念,等.以历史费用为基础的单病种定额标准测算研究[J].卫生经济研究,2017,(03):53.
[2]胡文杰,刘 明,徐俊英,等.医院病种成本核算的实践及探索[J].卫生经济研究,2018,(07):54.
[3]于保荣.按病例支付及医疗服务支付方式改革的实现条件——从DRGs、按病种付费、点数法付费及临床路径谈起[J].卫生经济研究,2018,(09):16.
　YU Bao-rong.Conditions for the Implementation of Reforms by Case Payment and Payment for Medical Services ——From DRGs，Case-based payments，Point payments，and Clinical pathways[J].Journal Press of Health Economics Research,2018,(03):16.
[4]朱 坤.县级公立医院按病种付费实施现状与建议 ——基于项目省的实践[J].卫生经济研究,2019,(03):5.
　ZHU Kun.Current Status and Recommendations for County-level Public Hospitals to Pay for Diseases——Based on the Practice of the Project Province[J].Journal Press of Health Economics Research,2019,(03):5.
[5]颜维华,谭华伟,张培林,等.日本诊断群分类支付制度改革经验及启示[J].卫生经济研究,2019,(03):39.
　YAN Wei-hua,TAN Hua-wei,ZHANG Pei-lin,et al.Japanese Diagnostic Group Classification Payment System Reform Experience and Enlightenment[J].Journal Press of Health Economics Research,2019,(03):39.
[6]张文娟,宋厚斌,王新虹,等.基于临床路径的按病种付费分段控制标准化构建[J].卫生经济研究,2019,(07):36.
　ZHANG Wen-juan,SONG Hou-bin,WANG Xin-hong,et al.Standardized Construction of Disease-based Segmentation Control Based on Clinical Path[J].Journal Press of Health Economics Research,2019,(03):36.
[7]朱 先,向 前.基于RBRVS与DRGs视角的按病种付费模式探讨[J].卫生经济研究,2020,(01):32.
　ZHU Xian,XIANG Qian.Discussion on the Disease-based Payment Model based on the Perspective of RBRVS and DRGs[J].Journal Press of Health Economics Research,2020,(03):32.
[8]李 芬,金春林,朱莉萍,等.以价值为导向的医保支付制度实施路径[J].卫生经济研究,2021,38(1):10.
　LI Fen,JIN Chun-lin,ZHU Li-ping,et al.The Implementation Path of Value-oriented Medical Insurance Payment System[J].Journal Press of Health Economics Research,2021,38(03):10.
[9]张 弘,丁 科,谢俊明,等.“疗效价值付费”下的中医优势病种DRG付费方案探索[J].卫生经济研究,2021,38(12):75.
　ZHANG Hong,DING Ke,XIE Jun-ming,et al.Exploration of DRG Payment Scheme for Dominant Diseases of Traditional Chinese Medicine under "Efficacy Value Payment"[J].Journal Press of Health Economics Research,2021,38(03):75.
[10]黄成凤,申丽君,杨燕绥.价值导向型医保付费政策效果探讨——基于柳州市中医优势病种的实证分析[J].卫生经济研究,2022,39(5):37.
　HUANG Cheng-feng,SHEN Li-jun,YANG Yan-sui.Discussion on the Effect of Value-Oriented Medical Insurance Payment Policy ——Based on Empirical Analysis in Liuzhou[J].Journal Press of Health Economics Research,2022,39(03):37.
[11]杨 菁,李梦滢,沈际勇.中医优势病种支付方式改革试点经验与启示[J].卫生经济研究,2023,40(12):33.
　YANG Jing,LI Mengying,SHEN Jiyong.Experience and Enlightenment of the Pilot Reform of Payment Methods for Dominant Diseases of Traditional Chinese Medicine[J].Journal Press of Health Economics Research,2023,40(03):33.
[12]于 伟,李佳宁,钟 璐,等.中医优势病种按疗效价值付费改革效果分析[J].卫生经济研究,2025,42(04):23.
　YU Wei,LI Jianing,ZHONG Lu,et al.Analysis of the Effect of the Payment Reform according to the Value of Efficacy for Dominant Diseases in Traditional Chinese Medicine[J].Journal Press of Health Economics Research,2025,42(03):23.

更新日期/Last Update: 2024-02-28