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新增医疗服务价格项目定价的影响因素、作用机理与锚定效应

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科学适宜的医疗服务项目定价机制是影响新医疗技术广泛应用的重要因素之一.文章在回顾国家层面新增医疗服务价格项目管理相关政策的基础上,结合地方实践,梳理了公立医院立项试行新增医疗服务价格项目自主定价的影响因素:按作用机制分为促进因素(测算成本、技术难度、风险程度)和制约因素(现行技术难度、风险程度相近项目价格,物耗、设备折旧占比,外省份批准设立新增医疗服务价格项目价格,医院等级,医师级别,财政补助,本地经济发展水平,患者承受能力).发挥新增医疗服务项目价格锚点作用,促进价格合理形成的政策建议包括:出台新增医疗服务价格项目管理指导意见,统一成本测算样表和取数口径;评估新增医疗服务价格项目价值,重大创新技术按绿色通道审核并允许溢价;监测和报告新增医疗服务价格项目试行期的服务量和运行成本,促进项目按期转正并定价.
Pricing Influencing Factors,Functionary Mechanism and Anchoring Effect of New Medical Service Price Items
Scientific and appropriate medical service pricing mechanism is one of the important factors affecting the wide application of new medical technology.On the basis of reviewing the policies related to the management of new medical service price items at the national level and combining with local practices,it sorts out the factors affecting the independent pricing of new medical service price items in public hospitals:according to the mechanism of action,it is divided into promoting factors(estimated cost,technical difficulty,risk degree)and restricting factors(price of items with similar technical difficulty and risk degree,material consumption,equipment depreciation ratio,price of new medical service items approved by foreign provinces,hospital grade,doctor grade,financial subsidy,local economic development level,patient affordability).The policy suggestions to give play to the role of the anchor point of the price of new medical service items and promote the reasonable formation of prices include:issuing guidance opinions on the management of new medical service price items,and unifying the sample table of cost calculation and the aperture of taking numbers;evaluate the value of new medical service price items,and review major innovative technologies according to the green channel and allow premium;monitor and report the service volume and operating cost of the new medical service price items during the pilot period,and promote the pricing of the new medical service items.

new medical service price itemcosttechnical difficultydegree of riskpriceanchor

郑大喜

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华中科技大学同济医学院附属同济医院 武汉 430030

新增医疗服务价格项目 成本 技术难度 风险程度 价格 锚定

2024

中国卫生经济
中国卫生经济学会,卫生部卫生经济研究所

中国卫生经济

CSTPCDCHSSCD北大核心
影响因子:1.524
ISSN:1003-0743
年,卷(期):2024.43(6)