[1]于 伟,孙亚玲,郑永菊,等.DIP支付改革对不同就医类型肺癌住院患者的影响研究[J].卫生经济研究,2025,42(08):75-78.
　YU Wei,SUN Yaling,ZHENG Yongju,et al.Study on the Impact of DIP Payment Reform on Lung Cancer Hospitalized Patients with Different Types of Medical Treatment[J].Journal Press of Health Economics Research,2025,42(08):75-78.
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DIP支付改革对不同就医类型肺癌住院患者的影响研究

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
42
期数:
2025年08期
页码:
75-78
栏目:
卫生服务利用
出版日期:
2025-07-31

文章信息/Info

Title:
Study on the Impact of DIP Payment Reform on Lung Cancer Hospitalized Patients with Different Types of Medical Treatment
作者:
于 伟1; 孙亚玲2; 郑永菊2; 唐小莉3; 黄 伟4; 陈 奕4; 陈 斌5; 李昀梦6; 曾雪琴2
1.西南医科大学附属医院，四川 泸州 646000
2.西南医科大学，四川 泸州 646000
3.营山县中医医院，四川 南充 637700
4.四川省泸州市医疗保障事务中心，四川 泸州 646000
5.阆中慈念医院，四川 南充 637400
6.营山县总医院，四川 南充 637700
Author(s):
YU Wei;  SUN Yaling;  ZHENG Yongju;  TANG Xiaoli;  HUANG Wei;  CHEN Yi;  CHEN Bin;  LI Yunmeng;  ZENG Xueqin
The Affiliated Hospital of Southwest Medical University, Luzhou Sichuan 646000, China
关键词:
按病种分值付费; 效果评估; 异地就医; 肺癌
Keywords:
DIP payment;  effect evaluation;  off-site medical care;  lung cancer
分类号:
F840.684
文献标志码:
A
摘要:
目的：探索按病种分值（DIP）支付改革对不同就医类型肺癌住院患者的影响，为深化医保支付方式改革提供参考。方法：以DIP国家试点城市L市为样本，采用双重差分分析方法，评估DIP支付改革对本地和异地就医肺癌患者的影响。结果：相对于异地就医患者，DIP支付改革后本地患者次均医疗费用下降，住院天数变化不明显；自付比、乙类先行支付占比显著下降，丙类自费占比显著增加；检查检验费占比显著下降，综合医疗服务费占比显著增加，耗材费占比和药品费占比无显著变化；接受放化疗和其他治疗方式的患者人数显著增加，手术治疗患者显著减少。结论：DIP支付改革能够降低本地患者的住院费用，但存在费用转移效应，需加强对医保政策范围外费用的监管；同时，重视价值导向，加快推进异地就医支付方式改革。
Abstract:
Objective To explore the impact of DIP payment reform on lung cancer hospitalized patients with different types of medical treatment, and to provide a reference for deepening the reform of health insurance payment methods. Methods Taking L city, a national pilot city for DIP, as a sample, the difference-in-difference method was used to assess the impact of DIP payment reform on lung cancer patients with local and off-site medical treatment. Results Compared with patients with off-site medical treatment, the average medical cost of local patients decreased after the DIP payment reform, and the change in the number of hospitalization days was not significant. The ratio of out-of-pocket payment and the proportion of Category B advance payment decreased significantly, and the proportion of out-of-pocket payment in Category C increased significantly. The proportion of examination and testing fee decreased significantly, the proportion of comprehensive medical services fee increased significantly, and the proportion of consumables fee and drugs fee did not change significantly. The number of patients receiving radiotherapy and other treatments increased significantly, and the number of patients receiving surgical treatments decreased significantly. Conclusion The DIP payment reform can reduce the hospitalization cost of local patients. However, there is a cost transfer effect. It is necessary to strengthen the supervision of fees outside the scope of health insurance policy. At the same time, value orientation is emphasized to accelerate the reform of health insurance payment method for off-site medical treatment.

参考文献/References:

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更新日期/Last Update: 2025-07-31