Negative medical behavior and its governance path under the background of DRG payment reform
With the original intention of reducing the cost of medical treatment for the public and impro-ving the quality of medical services,the reform of DRG payment system has been continuously promoted and im-plemented in China.While achieving the goals of standardizing medical behaviors,optimizing clinical pathways,and implementing graded diagnosis and treatment,there were still negative medical behaviors,which included pa-tient shifting,reduced quality,demand induction,and deliberate diversion of patients into costly disease groups,among hospitals and medical workers due to factors such as industry pressure transmission,misaligned subject in-formation,and insufficient regulatory mechanisms.Such is not conducive to the original effectiveness of DRG pay-ment system.Therefore,it is necessary to further enhance the standardization of DRG payment management,strengthen the information platform monitoring system,optimize the hospital operation and management mode,so as to better safeguard the legitimate rights and interests of patients,hospitals,medical insurance institutions and other parties,and continuously promote the healthy development of the pharmaceutical and healthcare industry.
DRG reformMedical insurance fundsNegative medical behaviorMedical servicesIm-proved regulationQuality improvementOperation management
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