The Impact of the DRG Payment System on the High-quality Development of Public Hospitals
陈蕴婷 1胡牧 2金承刚3
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作者信息
1. 北京师范大学政府管理学院,北京 100875
2. 北京大学第三医院医保办,北京 100191
3. 北京师范大学社会学院,北京 100875
折叠
摘要
"十四五"期间,我国公立医院进入高质量发展阶段,医保支付方式改革成为促进公立医院高质量发展的关键举措.然而,从目前情况来看,尽管疾病诊断相关分组(diagnosis related group,DRG)支付方式改革在缩短平均住院日、提高难度系数、降低中低风险病组死亡率方面取得了一定成绩,但也存在着配套政策不完善、分类系统需更新、病案首页质量参差不齐、编码质量急需提高,以及如何处理新技术的使用等诸多问题与挑战.因此,重新审视DRG支付方式对公立医院高质量发展的影响,不仅有助于更加清晰地认识当前所面临的困境,还能为未来进一步完善和优化医保支付方式提供重要参考依据.
Abstract
During the 14th Five-Year Plan period,public hospitals in China have entered a phase of high-quality development,with health insurance payment system reforms becoming a crucial means to promote this advancement.However,from the current situation,although the diagnosis related group(DRG)payment reform has made great achievements in shortening the average length of stay,improving the case-mix index,and reducing the mortality rate of low-risk groups,there are also many problems and challenges such as incomplete supporting policies,the classification system needs to be updated,the quality of medical record home pages va-ries,the quality of coding urgently needs to be improved,and how to deal with the use of new technologies.Thus,revisiting the impact of the DRG payment method on the high-quality development of public hospitals will not only help to understand the current challenges more clearly,but also offer valuable insights for further im-proving and optimizing the payment method of health insurance in the future.
关键词
医保支付/DRG支付/高质量发展/公立医院
Key words
health insurance payment/DRG payment/high-quality development/public hospitals
维普
万方数据