[1]杨 菁,李梦滢,沈际勇.中医优势病种支付方式改革试点经验与启示[J].卫生经济研究,2023,40(12):33-38.
 YANG Jing,LI Mengying,SHEN Jiyong.Experience and Enlightenment of the Pilot Reform of Payment Methods for Dominant Diseases of Traditional Chinese Medicine[J].Journal Press of Health Economics Research,2023,40(12):33-38.
点击复制

中医优势病种支付方式改革试点经验与启示
分享到:

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
40
期数:
2023年12期
页码:
33-38
栏目:
筹资与支付
出版日期:
2023-11-30

文章信息/Info

Title:
Experience and Enlightenment of the Pilot Reform of Payment Methods for Dominant Diseases of Traditional Chinese Medicine
作者:
杨 菁1李梦滢2沈际勇2
1.浙江大学医学院附属邵逸夫医院,浙江 杭州 310020
2.清华大学附属北京清华长庚医院/清华大学临床医学院,北京 102218
Author(s):
YANG Jing LI Mengying SHEN Jiyong
Zhejiang University School of Medicine, Sir Run Run Shaw Hospital,Hangzhou Zhejiang 310020, China
关键词:
中医优势病种按病种付费支付方式改革
Keywords:
dominant diseases of traditional Chinese medicine disease category-based medical insurance payment(DB-MIP) reform of payment methods
分类号:
R19
文献标志码:
A
摘要:
当前,部分医疗机构和统筹区开展了中医按病种付费的探索,如山东威海的单病种管理、福建泉州的按病种收付费、江苏南京的按病种付费、江西柳州的按疗效价值付费和按优势病种付费等,积累了宝贵的经验。现阶段全国范围内大规模推广中医按病种付费仍面临较多挑战,对此提出建议:建立“国家级-省级-统筹区”三级联动机制,国家医保信息平台应充分考虑中医按病种付费经办服务和基金监管需求,统筹考虑待遇的绝对公平和相对公平,因地制宜推动中医支付方式改革。
Abstract:
At present, in some medical institutions and coordinating areas, disease category-based medical insurance payment(DB-MIP) of traditional Chinese medicine has been explored, such as single disease management in Weihai, payment by disease category in Quanzhou and Nanjing, payment by therapeutic value and payment by dominant diseases in Liuzhou, and has achieved positive results. However, there are still many challenges in promoting DB-MIP of traditional Chinese medicine on a large scale nationwide, and suggestions are proposed for this. It is necessary to establish a three-level linkage mechanism of "national level, provincial level, and coordinating area", fully consider the needs of services and fund supervision for DB-MIP of traditional Chinese medicine for the national medical insurance information platform, comprehensively consider the absolute and relative fairness of benefits, and promote the reform of payment methods of traditional Chinese medicine according to local conditions.

参考文献/References:

[1] 刘红玉.中医按病种付费方式探讨[D].武汉:华中科技大学,2013.
[2] 马军.建立符合中医药特点的医保支付方式[N].华兴时报.
[3] 朱静.中医药在医保现有制度下的窘境和发展[J].天津社会保险,2017(5):53-55.
[4] 王静,钟力炜,言行,等.上海市中医医院医保支付改革实践探索[J].中国医院管理,2022,42(3):70-73.
[5] 黄蓓.浙江基层中医门诊常见病纳入按病种付费[J].中医药管理杂志,2018,26(14):52.
[6] 孙璨,冯占春.中医院按病种付费支付方式改革现状分析[J].中国医院,2022,26(6):16-18.
[7] 刁仁昌,薛虹,吴尚勇.江苏南京中医DRG的分组逻辑与改革成效[J].中国卫生,2022(8): 61-64.
[8] 罗乃莹.山东威海探索符合中医药服务特点的医保支付方式[J].中医药管理杂志,2019,27(23):15.
[9] 李小玲,黄晓云,李鑫.福建泉州:探索中医药特色支付方式[J].中国卫生,2022(8):67-69.
[10] 黄成凤,申丽君,杨燕绥.价值导向型医保付费政策效果探讨——基于柳州市中医优势病种的实证分析[J].卫生经济研究,2022,39(5):37-41.

相似文献/References:

[1]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[J].卫生经济研究,2017,(03):53.
[2]胡文杰,刘 明,徐俊英,等.医院病种成本核算的实践及探索[J].卫生经济研究,2018,(07):54.
[3]于保荣.按病例支付及医疗服务支付方式改革的实现条件——从DRGs、按病种付费、点数法付费及临床路径谈起[J].卫生经济研究,2018,(09):16.
 YU Bao-rong.Conditions for the Implementation of Reforms by Case Payment and Payment for Medical Services ——From DRGs,Case-based payments,Point payments,and Clinical pathways[J].Journal Press of Health Economics Research,2018,(12):16.
[4]朱 坤.县级公立医院按病种付费实施现状与建议 ——基于项目省的实践[J].卫生经济研究,2019,(03):5.
 ZHU Kun.Current Status and Recommendations for County-level Public Hospitals to Pay for Diseases——Based on the Practice of the Project Province[J].Journal Press of Health Economics Research,2019,(12):5.
[5]颜维华,谭华伟,张培林,等.日本诊断群分类支付制度改革经验及启示[J].卫生经济研究,2019,(03):39.
 YAN Wei-hua,TAN Hua-wei,ZHANG Pei-lin,et al.Japanese Diagnostic Group Classification Payment System Reform Experience and Enlightenment[J].Journal Press of Health Economics Research,2019,(12):39.
[6]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.
 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,(12):36.
[7]朱 先,向 前.基于RBRVS与DRGs视角的按病种付费模式探讨[J].卫生经济研究,2020,(01):32.
 ZHU Xian,XIANG Qian.Discussion on the Disease-based Payment Model based on the Perspective of RBRVS and DRGs[J].Journal Press of Health Economics Research,2020,(12):32.
[8]李 芬,金春林,朱莉萍,等.以价值为导向的医保支付制度实施路径[J].卫生经济研究,2021,38(1):10.
 LI Fen,JIN Chun-lin,ZHU Li-ping,et al.The Implementation Path of Value-oriented Medical Insurance Payment System[J].Journal Press of Health Economics Research,2021,38(12):10.
[9]张 弘,丁 科,谢俊明,等.“疗效价值付费”下的中医优势病种DRG付费方案探索[J].卫生经济研究,2021,38(12):75.
 ZHANG Hong,DING Ke,XIE Jun-ming,et al.Exploration of DRG Payment Scheme for Dominant Diseases of Traditional Chinese Medicine under "Efficacy Value Payment"[J].Journal Press of Health Economics Research,2021,38(12):75.
[10]黄成凤,申丽君,杨燕绥.价值导向型医保付费政策效果探讨——基于柳州市中医优势病种的实证分析[J].卫生经济研究,2022,39(5):37.
 HUANG Cheng-feng,SHEN Li-jun,YANG Yan-sui.Discussion on the Effect of Value-Oriented Medical Insurance Payment Policy ——Based on Empirical Analysis in Liuzhou[J].Journal Press of Health Economics Research,2022,39(12):37.
[11]岳铭坤,李 凯,黄 娜,等.按病种付费对中医优势病种住院费用的影响研究 ——基于PSM-DID法[J].卫生经济研究,2024,41(03):62.
 YUE Mingkun,LI Kai,HUANG Na,et al.Study the Impact of DRG on the Hospitalization Expenses of the Dominant Diseases of Traditional Chinese Medicine ——Based on PSM-DID Method[J].Journal Press of Health Economics Research,2024,41(12):62.

更新日期/Last Update: 2023-11-30