[1]骆函绮.基于史密斯模型的DRG点数法付费政策执行偏差分析及对策研究[J].卫生经济研究,2024,41(05):48-51,57.
 LUO Hanqi.Study on implementation Deviation and Countermeasures of the Policy for DRG Point Method Payment based on Smith's Model[J].Journal Press of Health Economics Research,2024,41(05):48-51,57.
点击复制

基于史密斯模型的DRG点数法付费政策执行偏差分析及对策研究
分享到:

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
41
期数:
2024年05期
页码:
48-51,57
栏目:
医疗保障
出版日期:
2024-04-23

文章信息/Info

Title:
Study on implementation Deviation and Countermeasures of the Policy for DRG Point Method Payment based on Smith's Model
作者:
骆函绮1
1.清华大学,北京 100084
Author(s):
LUO Hanqi
Tsinghua University, Beijing 100084, China
关键词:
医保支付方式改革史密斯政策执行模型总额控制DRG点数法付费
Keywords:
health insurance payment method reform Smith's policy implementation process model total control DRG point method payment
分类号:
R19;F840.684
文献标志码:
A
摘要:
基于史密斯政策执行模型,以浙江省义乌市为例,通过理想化政策、执行机构、目标群体和政策环境四个方面,对总额控制下DRG点数法付费政策执行偏差进行分析,提出修正政策执行偏差的对策,为深化医保支付方式改革提供实证依据。
Abstract:
Based on Smith's policy implementation process model, taking Yiwu City of Zhejiang Province as an example, the implementation deviation of the policy for DRG point method payment under total control was analyzed through four aspects: idealized policy, policy implementation subject, policy target group and policy implementation environment. The countermeasures were put forward to correct the policy implementation deviation, so as to provide empirical evidence for deepening the reform of health insurance payment method.

参考文献/References:

[1] 中国政府网.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).https://www.gov.cn/gongbao/content/2017/content_5210497.htm.
[2] 中国政府网.浙江全面启动县域医共体基本医保支付方式改革[EB/OL].(2019-07-17).https://www.gov.cn/xinwen/2019-07/17/content_ 5410602.htm.
[3]义乌政府网.义乌市医疗保障局2021年工作思路[EB/OL].(2021-01-05).http://www.yw.gov.cn/art/2021/1/5/art_1229135341_37852 28.html.
[4] Wu Q,Yin W,Ma H,et al.Implementation of supportive policies for family doctor services based on Smith's policy implementation process model[J].Chinese General Practice,2018,21(22): 2655.
[5] 张礼亮,马骋宇,张婧怡,等.我国全民参保政策执行的制约因素和治理策略研究——基于史密斯政策执行模型[J].卫生经济研究,2024,41(03):19-23.
[6] 邵宁军,严欣.金华医保“病组点数法”付费改革成效评析[J].中国医疗保险,2018(04):41-43.
[7] 潘春燕.DRG支付方式的实践探讨——以JH市试点情况为例[J].卫生经济研究,2019,36(08):38-41.
[8] 刘瑶瑶,周典,田帝,等.医保、医管双视角下DRG在公立医院高质量发展中的协同效应探究[J].中国医院管理,2022,42(10): 5-8.
[9] 董志勇,赵晨晓.“新医改”十年:我国医疗卫生事业发展成就、困境与路径选择[J].改革,2020(09):149-159.
[10] 宋桂杭,刘志新,杨仁前.DRG/DIP付费下开展中医优势病种的政策思考[J].中国医疗保险,2023(07):23-29.
[11] 高阳,祖亮华,刘冉,等.中医纳入疾病诊断相关分组的思考[J].卫生经济研究,2023,40(11):5-8.
[12] 韦玮,郑秉文.我国医保支付方式本土化改革历程与价值导向完善建议[J].中国医疗保险,2023(12):13-20.
[13] 胡善联.五大创新五大关键——深度解读医保重大改革顶层设计[J].中国医疗保险,2020(05):5-6.
[14] 周鹏飞,李运明,杨孝光,等.国内外DRG研究应用概述和医院开展DRG付费方式改革的作用及存在问题探讨[J].卫生软科学,2023,37(02):6-10
. [15] 郑盼,郭佳奕,陈芳,等.浙江金华市“病组点数法”付费的特病单议专家评审病例分析[J].中国医院,2020,24(06):18-20.

相似文献/References:

[1]李 萍,汤少梁.后疫情时代药品集中带量采购政策制约因素与执行路径——基于史密斯政策执行模型[J].卫生经济研究,2021,38(4):32.
 LI Ping,TANG Shao-liang.The Restrictive Factors and Implementation Path of Drug Centralized Quantity Purchase Policy in the Post-epidemic Era——Based on Smith Policy Implementation Model[J].Journal Press of Health Economics Research,2021,38(05):32.
[2]宋生来,胡小波,胡晓彦.湖州市医共体综合付费方式改革的经验和启示——以德清县为例[J].卫生经济研究,2021,38(12):25.
 SONG Sheng-lai,HU Xiao-bo,HU Xiao-yan.Experience and Enlightenment of Comprehensive Payment Method Reform in Huzhou Medical Alliance——Taking Deqing County as Example[J].Journal Press of Health Economics Research,2021,38(05):25.
[3]陈其根,周晗彬,李伟峰,等.DRG点数法推进医保精细化管理的实证研究——以浙江省嘉兴市为例[J].卫生经济研究,2021,38(12):29.
 CHEN Qi-gen,ZHOU Han-bin,LI Wei-feng,et al.An Empirical Study on Promoting Fine Management of Medical Insurance by DRG Point Method——Taking Jiaxing City, Zhejiang Province as an Example[J].Journal Press of Health Economics Research,2021,38(05):29.
[4]陈芬芳,姜建琼,韦庆钢,等.DRG下长期住院病例按床日点数付费的实践探索[J].卫生经济研究,2021,38(12):51.
 CHEN Fen-fang,JIANG Jian-qiong,WEI Qing-gang,et al.Practical Exploration of Long-term Hospitalized Cases under DRG Per-diem Payment[J].Journal Press of Health Economics Research,2021,38(05):51.
[5]熊 蔓,伍林生.重庆市DRG实施成效评估及问题分析——基于模拟运行阶段[J].卫生经济研究,2022,39(7):28.
 XIONG Man,WU Linsheng.Evaluation of Implementation Effectiveness and Problem Analysis of DRG in Chongqing ——Based on Simulation Operation Phase[J].Journal Press of Health Economics Research,2022,39(05):28.
[6]刘玉新,莫颖宁,郭德第.药品集中带量采购政策执行现状与接续建议——基于史密斯政策执行模型[J].卫生经济研究,2023,40(7):20.
 LIU Yuxin,MO Yingning,GUO Dedi.Implementation Situation and Continuation Suggestions of the Policy of Centralized Volume-based Procurement of Drugs ——Based on Smith Policy Implementation Process Model[J].Journal Press of Health Economics Research,2023,40(05):20.
[7]李祖兰,周戈耀,毛 佳,等.贵州省中医优势病种支付方式改革推行的影响因素研究[J].卫生经济研究,2023,40(10):61.
 LI Zulan,ZHOU Geyao,MAO Jia,et al.Study on the Influencing Factors of the Implementation of Payment Reform for Dominant Diseases of Traditional Chinese Medicine in Guizhou Province[J].Journal Press of Health Economics Research,2023,40(05):61.
[8]牛 琨,贺 婷,袁 勇.按病种分值付费背景下医院科室收入核算模式探索[J].卫生经济研究,2024,41(02):85.
 NIU Kun,HE Ting,YUAN Yong.Exploration on Revenue Accounting Model for Hospital Departments under the Background of Diagnosis-Intervention Packet[J].Journal Press of Health Economics Research,2024,41(05):85.
[9]张晓云.医疗机构疾控监督员政策执行情况研究 ——基于史密斯政策执行模型[J].卫生经济研究,2024,41(05):81.
 ZHANG Xiaoyun.Study on the Implementation of Disease Control Supervisor Policy in Medical Institutions 2.浙江大学公卫学院社会医学系,医学部卫生政策学研究中心, 浙江 杭州 310058 ——Based on Smith's Policy Implementation Process Model[J].Journal Press of Health Economics Research,2024,41(05):81.

更新日期/Last Update: 2024-04-23