[1]李 希,邓世虎,彭美华,等.中医优势病种DRG付费：政策、难点及对策[J].卫生经济研究,2025,42(01):39-42,47.
　LI Xi,DENG Shihu,PENG Meihua,et al.DRG Payment for Dominant Diseases of Traditional Chinese Medicine: Policies, Difficulties and Countermeasures[J].Journal Press of Health Economics Research,2025,42(01):39-42,47.
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中医优势病种DRG付费：政策、难点及对策
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
42
期数:
2025年01期
页码:
39-42,47
栏目:
改革探索
出版日期:
2025-01-07

文章信息/Info

Title:
DRG Payment for Dominant Diseases of Traditional Chinese Medicine: Policies, Difficulties and Countermeasures
作者:
李 希1; 邓世虎2; 彭美华1; 吴靖文2; 周望苏2; 余丽君2
1.成都中医药大学管理学院，四川 成都 611137
2.四川省眉山市医疗保障局，四川 眉山 620020
Author(s):
LI Xi;  DENG Shihu;  PENG Meihua;  WU Jingwen;  ZHOU Wangsu;  YU Lijun
School of Management, Chengdu University of Tradition Chinese Medicine, Chengdu Sichuan 611137,China
关键词:
中医优势病种; 中医DRG付费; 医保支付方式改革
Keywords:
dominant diseases of traditional Chinese medicine;  traditional Chinese medicine DRG payment;  reform of medical insurance payment method
分类号:
R19
文献标志码:
A
摘要:
目的：分析各地中医优势病种DRG付费政策，为推进医保支付方式改革提供实证参考。方法：通过政策梳理和案例研究，分析中医DRG付费政策的实施成效及难点，提出对策建议。结果：各地中医DRG付费政策差异较大，存在中医优势病种概念不明、基层医疗机构覆盖不足、治疗质量考核规则不统一、病种遴选机制有待完善、医保-医院协同有待加强等难点。结论：加强部门协同，鼓励医院深度参与中医DRG付费；扩大政策覆盖范围，加大基层倾斜力度；精准界定中医优势病种，完善质量考核规则。
Abstract:
Objective To analyze the payment policies of DRG for dominant diseases of traditional Chinese medicine in various places, and to provide empirical reference for promoting the reform of medical insurance payment methods. Methods Through literature analysis and case study, the implementation effect and difficulties of DRG payment policies in traditional Chinese medicine were analyzed, and countermeasures and suggestions were put forward. Results There were significant differences in the DRG payment policies for traditional Chinese medicine among different regions. There were difficulties such as unclear concepts of dominant diseases in traditional Chinese medicine, insufficient coverage of primary medical institutions, inconsistent assessment rules for treatment quality, incomplete disease selection mechanisms, and the need to strengthen the collaboration between medical insurance and hospitals. Conclusion It is necessary to strengthen departmental cooperation and encourage hospitals to deeply participate in the DRG payment of traditional Chinese medicine, expand the policy coverage and intensify the tilt towards primary level, and accurately define the dominant diseases of traditional Chinese medicine and improve the quality assessment rules.

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更新日期/Last Update: 2025-01-07