[1]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):36-38.
　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,(07):36-38.
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基于临床路径的按病种付费分段控制标准化构建
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
期数:
2019年07期
页码:
36-38
栏目:
成本与费用
出版日期:
2019-06-24

文章信息/Info

Title:
Standardized Construction of Disease-based Segmentation Control Based on Clinical Path
作者:
张文娟1; 宋厚斌1; 王新虹1; 江 茹1; 曹云博1
1.连云港市第一人民医院，江苏 连云港 222061
Author(s):
ZHANG Wen-juan; SONG Hou-bin; WANG Xin-hong; JIANG Ru; CAO Yun-bo
Lianyungang First People's Hospital，Lianyungang Jiangsu 222061，China
关键词:
临床路径; 医保支付方式; 按病种付费; 分段控制
Keywords:
clinical pathway; medical insurance payment method; payment by disease; segmentation control
分类号:
F840.684
文献标志码:
A
摘要:
以连云港市某三甲医院为例，选取临床科室备受关注、亟待解决的6个代表性病种，通过问卷调查分析医务人员对按病种付费实施现状的满意度。根据调查结果，将传统的按病种付费细化，分为医疗、护理、手术、麻醉、病理五部分，基于临床路径规范并结合物价系统，测算制定各分段的费用标准，借助信息化手段，最终实现按病种付费分段控制标准化。
Abstract:
Taking a IIIA hospital in Lianyungang as an example，six representative diseases that have received much attention and showed urgent need to be solved in the clinical department were selected. The questionnaire survey was conducted to collected date of the satisfaction of medical staff on the implementation status of the disease-based payment. According to the survey results，the traditional case-based payment refinement was divided into five parts: medical，nursing，surgery，anesthesia，and pathology. Based on the clinical path specification and combined with the price system，the cost standard for each segment was calculated. In the end，standardization of disease-based segmentation control is realized via information technology.

参考文献/References:

[1] 邹伏英，熊瑶，邹俐爱，等．按病种收(付)费相关规范研究探讨[J]．中国卫生事业管理，2017（8）：589-592．
[2] 丁海霞，万彬，张蔚，等．江苏省实施医保基金按单病种付费现状研究[J]．中国医疗保险，2017（6）：49-52．
[3] JACKSON T, DIMITROPOULOS V, MADDEN R, et al. Australian diagnosis related groups: Drivers of complexity adjustment[J]. Health Policy, 2015, 119(11): 1433-1441.
[4] 罗琪，应可满.医疗保险按病种付费研究综述[J].中国卫生事业管理，2012,29(4):264-267.
[5] 李贤华，郑战战，沈洋，等．疾病诊断相关组在医院绩效考核中的评价[J]．解放军医院管理杂志，2017（6）：505-508．
[6] RIMLER S B, GALE B D, REEDE D L. Diagnosis-related Groups and Hospital Inpatient Federal Reimbursement[J]. Radiographics a Review Publication of the Radiolog, 2015, 35(6): 1825-1834.
[7] 莫佳瑜，路彦钧，孙宇骏，等．单病种住院费用分析及绩效管理模式探讨——以结直肠癌手术为例[J]．中国社会医学杂志，2017（1）：84-86．
[8] 郭文博，张岚，况景勤，等．单病种定额支付对医院经济运行的影响[J]．卫生经济研究，2017（8）：54-56．
[9] 沈张伟，戴色莺. 医院实行按病种付费的利弊及建议[J].中国农村卫生事业管理，2016,36(3):342-344.
[10] 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——以脑梗死为例[J]．卫生经济研究，2017（3）：53-56．

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更新日期/Last Update: 2019-06-24