[1]陆文婷,张海斌.按病种付费在门诊服务中的适应性分析[J].卫生经济研究,2026,43(05):51-53.
　LU Wenting,ZHANG Haibin.Adaptability Analysis of Case-Based Payment in Outpatient Services[J].Journal Press of Health Economics Research,2026,43(05):51-53.
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按病种付费在门诊服务中的适应性分析

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
43
期数:
2026年05期
页码:
51-53
栏目:
医疗保障
出版日期:
2026-04-24

文章信息/Info

Title:
Adaptability Analysis of Case-Based Payment in Outpatient Services
作者:
陆文婷1; 张海斌2
1.上海交通大学医学院附属第九人民医院，上海 200011
2.上海申康发展中心，上海 200041
Author(s):
LU Wenting;  ZHANG Haibin
Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
关键词:
按病种付费; 门诊服务; 医保管理; 政策适应性
Keywords:
case-based payment;  outpatient services;  medical insurance management;  policy adaptability
分类号:
F840.684
文献标志码:
B
摘要:
按病种付费已在我国住院服务中全面推行，对控制医疗费用增长和提升医疗服务质量具有重要作用。门诊服务与住院服务在医疗路径、病案信息、计费方法和医保支付管理方面存在显著差异，在门诊服务中全面推行按病种付费存在一定困难。上海市选择诊断明确、治疗路径清晰、成本结构相对稳定的口腔正畸专科病种，试点门诊按病种付费，在诊疗流程稳定性和费用控制方面取得了良好成效，可以为推行门诊服务按病种付费提供实证参考。
Abstract:
Case-based payment has been fully implemented in inpatient services in China, playing an important role in controlling medical cost growth and improving the quality of medical services. There are significant differences between outpatient services and inpatient services in terms of clinical pathways, medical record information, billing methods, and medical insurance payment management, making it difficult to fully implement case-based payment in outpatient services. Shanghai selected orthodontic specialty diseases with clear diagnoses, clear treatment pathways, and relatively stable cost structures to pilot case-based payment in outpatient services, achieving good results in terms of treatment process stability and cost control, which can provide empirical references for implementing case-based payment in outpatient services.

参考文献/References:

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更新日期/Last Update: 2026-04-24