病例组合方法及应用探讨  

Delving into Casemix and its application

作　　者：徐金耀[1] 

机构地区：[1]上海交通大学公共卫生学院,上海200025

出　　处：《中国卫生经济》2006年第9期53-55,共3页Chinese Health Economics

摘　　要：为了保证卫生资源分配的有效性和公平性,我国社会医疗保险制度中有必要引入病例组合(Casemix)的管理模式,病例组合是迄今为止国际上较为理想的卫生资源管理及疾病组合模式,病例组合的实施还能够帮助卫生管理机构建立医疗服务质量的评判标准及医疗机构和个人医疗服务质量与效率的比较标准,从而促进医疗服务质量与效率以及我国公共卫生管理水平的全面提高。The Casemix refers to the type or mix of patients treated in the different health service institutions. Its application in health funding can ensure comparative validity and fairness of health resource assignment. In addition, through Casemix system, health service institutions, health funders, patients and health regulators can gain an understanding of the patients being treated, the costs incurred, which offers the opportunity for improvement in health service quality and efficiency. The Casemix can also help establish the benchmark of health service institutions and provide a tool for health regulator to evaluate the health service efficiency and quality of different health service institutions, and support health service institutions＇ internal management and strategic plan.

关 键 词：病例组合 卫生资源 疾病诊断相关组 

分 类 号：F842.6[经济管理—保险]