[1]王思敏,徐 伟,崔子丹,等.价值医疗导向的医保支付方式初探——以中美典型按价值付费项目为例[J].卫生经济研究,2019,(02):9-12.
　WANG Si-min,XU Wei,CUI Zi-dan,et al.Preliminary Study on the Value-based Medical Insurance Payment Method——Taking the Typical Value-based Payment Project between China and the United States as An Example[J].Journal Press of Health Economics Research,2019,(02):9-12.
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价值医疗导向的医保支付方式初探
——以中美典型按价值付费项目为例
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
期数:
2019年02期
页码:
9-12
栏目:
专题研究
出版日期:
2019-02-01

文章信息/Info

Title:
Preliminary Study on the Value-based Medical Insurance Payment Method
——Taking the Typical Value-based Payment Project between China and the United States as An Example
作者:
王思敏1; 徐 伟1; 崔子丹1; 施琼华1
1.中国药科大学国际医药商学院，江苏 南京 211198
Author(s):
WANG Si-min; XU Wei; CUI Zi-dan; SHI Qiong-hua
School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing Jiangsun 211198, China
关键词:
按价值付费; 医保支付方式; 价值医疗
Keywords:
Value-based payment;  medical insurance payment method;  value medical
分类号:
F840.684
文献标志码:
A
摘要:
按价值付费是通过质量评价体系和奖惩机制来激励医疗服务提供者提高医疗质量、改善患者就医体验、减少不必要医疗费用的一种新型支付方式。本文阐述了按价值付费的内涵与意义，从筹资与支付模式、医疗质量评价体系、绩效得分评价方法三个角度对比分析了美国Mediacre“以价值为本的医疗服务购买项目”和我国浙江省“肝移植术按绩效付费项目”的异同，以期为我国医保支付方式改革提供借鉴。
Abstract:
Paying by value is a new type of payment method that encourages medical service providers to improve medical quality, improve patient medical experience, and reduce unnecessary medical expenses through quality evaluation system and reward and punishment mechanism. This paper expounded the connotation and significance of value-based payment, and compared the similarities and differences between the US Mediacre "value-based medical service purchase project" and Zhejiang Province in China "liver transplantation according to performance-paying projects" from the perspectives of financing and payment model, medical quality evaluation system and performance score evaluation method, in order to provide reference for the reform of China's medical insurance payment methods.

参考文献/References:

[1] Germán M. Izón, Pardini CA. Association Between Medicare’s Mandatory Hospital Value-Based Purchasing Program and Cost Inefficiency[J]. Applied Health Economics & Health Policy, 2017, 16(4):1-12.
[2] 国务院办公厅.关于进一步深化基本医疗保险支付方式改革的指导意见[EB/OL]. (2017-06-20) [2018-12-04]. http://www.gov.cn/zhengce/content/2017-06/28/content_5206315.htm.
[3] Rosenbaum L. The whole ball game--overcoming the blind spots in health care reform[J]. N Engl J Med, 2013, 368(10):959-962.
[4] 顾昕,郭科.从按项目付费到按价值付费:美国老人医疗保险支付制度改革[J].东岳论丛,2018,39(10):79-87.
[5] Yasaitis L, Fisher E S, Skinner J S , et al. Hospital Quality And Intensity Of Spending: Is There An Association?[J]. Health Affairs, 2009, 28(4): w566.
[6] 贾洪波, 王清河. 医疗保障按绩效付费方式的文献综述[J]. 中国卫生经济, 2015, 34(3):26-28.

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更新日期/Last Update: 2019-01-29