我国医疗服务按病种定价模型的构建与实证分析  

Construction and Empirical Research of Disease Pricing Model for Medical Service in China

作　　者：龙钊[1] 谢金亮[1] 熊瑶[2] 王晓佳[3] 王秀英[1] 邹俐爱[1] 

机构地区：[1]南方医科大学南方医院,广州510515 [2]南方医科大学人文与管理学院,广州510515 [3]南方医科大学第五附属医院,广州510515

出　　处：《中国卫生经济》2015年第5期55-57,共3页Chinese Health Economics

基　　金：广东省科技计划项目(2010B080701018);广东省卫生经济学会2013年度科研项目(20131001-15)

摘　　要：目的:构建科学、合理的病种定价模型,推动我国医疗服务按病种付费制度改革。方法:运用经济学原理提出相关理论假设,同时应用静态分析和动态分析相结合、定性分析和定量分析相结合的方法,构建病种定价模型并进行实证分析。结果:确定影响病种价格的决定因素,首次提出相对技术难度线和相对风险程度线等核心概念,进而提出病种定价模型的数学形式,并在该模型下实证分析了3个样本病种的价格水平。结论:利用该模型得到的价格能确保补偿病种的资源消耗;同时,低技术,低风险的病种价格将进一步得到控制,而高技术、高风险的病种价格将得到更充分体现。该定价模型符合医疗服务的价值规律。Objective:To construct the scientific and reasonable pricing model for the disease so that to promote the reform of Diag-nosis Related Groups(DRGs) for Chinese medical services.Methods:Related theoretical assumption was put forward based on econom-ic theories.Static analysis and dynamic analysis were combined while qualitative and quantitative analysis combined to construct thepricing model and make empirical analysis.Results:With the determinant factor of disease price being confirmed,and simultaneous-ly,the core concept like Relative Technology Line and Relative Risk Line first being proposed,the mathematical form of Cost-Tech-nology-Risk Pricing Model was put forward,and,the price level of 3 samples of diseases was analyzed empirically.Conclusion:Theresource consumption of diseases could be compensated through the price calculated by the pricing model;while the price of low tech-nology and risk disease would be further under control,however,the price of high technologies and risk diseases would be more fullyreflected.The pricing model accords with the value of law of medical service.

关 键 词：按病种付费 病种价格 定价模型 

分 类 号：R197.1[医药卫生—卫生事业管理]