DIP支付方式下医保供给侧政策协同对费用控制的影响研究
Research on the impact of supply side policy coordination of medical insurance on cost control under DIP payment method
林坤河 1上官业声 2饶娅琦 2彭静 3陈翼 3姚轶凡 1熊英贝 1项莉4
作者信息
- 1. 华中科技大学同济医学院医药卫生管理学院 湖北武汉 430030
- 2. 宜昌市医疗保障局 湖北宜昌 420500
- 3. 宜昌市医疗保障服务中心 湖北宜昌 420500
- 4. 华中科技大学同济医学院医药卫生管理学院 湖北武汉 430030;国家医疗保障研究院华科基地 湖北武汉 430030
- 折叠
摘要
目的:本研究旨在探索DIP支付方式与其他医保供给侧政策间的协同效果.方法:以全国DIP改革试点城市A市为处理组,未改革城市B市为对照组进行比较研究.收集2019-2022 年共1 120 个公立医疗机构样本,采用双重差分法对住院医疗总费用及部分费用结构进行分析.结果:A市DIP改革对医疗机构住院医疗总费用、住院检查化验总费用产生显著的抑制效应,对住院药品总费用和住院材料总费用未产生影响.结论:DIP支付方式发挥显著控费效果,住院医疗总费用得到有效控制;单纯采取调价政策与集采政策的控费效果尚有不足;DIP与其他供给侧政策协同,促进医疗费用结构更加合理.建议医保部门注重发挥供给侧政策协同作用,共同推动医保基金使用效率提升.
Abstract
Objective:This study aims to explore the synergistic effects of DIP and other medical insurance supply-side policies.Method:City A that has piloted DIP reform was set as the treatment group,and City B without reform was set as the control group.A total of 1 120 public medical institution samples from 2019 to 2022 were collected.The total medical expenses during hospitalization and some structural expenses were analyzed using DID method.Result:DIP had a significant inhibitory effect on the medical expenses,and the expenses of checkups and examinations during hospitalization in city A,but had no impact on the drug and the material expenses during hospitalization.Conclusion:DIP played a significant cost control role and effectively controlled the total medical expenses during hospitalization.The synergistic effects of price adjustment of medical services policy and national centralized drug/material procurement policy on cost control were insufficient.DIP synergized with other supply-side policies to promote rational medical cost structure.It is suggested that medical insurance departments should focus on the synergistic effects of medical insurance supply-side policies to jointly improve the efficiency of medical insurance fund utilization.
关键词
DIP支付方式/供给侧改革/医疗服务价格调整/药品/耗材集中采购Key words
DIP payment method/Supply side reform/Price adjustment of medical services policy/National centralized drug/material procurement policy引用本文复制引用
基金项目
国家自然科学基金项目(72174068)
中央高校基本科研业务费专项资金资助项目(YCJJ20242228)
出版年
2024
NETL
NSTL
万方数据