祥云县按疾病诊断组(DRGs)支付方式改革实践  

Reform and practice of payment mode according to disease diagnosis related groups in Xiangyun county

作　　者：彭琰[1] 严莉[1] 王兴龙 唐国政[1] 匡华刘望 王联熙 PENG Yan YAN Li WANG Xing-long TANG Guo-zhen KUANGHUA Liu - wang WANG Lian - xi(Yunaan Medical Information Research Institute, Kunming Yunaan 650031, China Xiangyun County People＇s Hospital, Xiangyun Yunnan 672100, China Yunnan Audit Bureau, Kunming Yunnan 650000, China)

机构地区：[1]云南省医学信息研究所,云南昆明650031 [2]祥云县人民医院,云南祥云672100 [3]云南省审计厅,云南昆明650000

出　　处：《卫生软科学》2017年第3期6-8,共3页Soft Science of Health

基　　金：云南省审计厅;云南省财政厅联合资助项目--云南省城乡居民基本医疗保险支付方式改革研究

摘　　要：对云南省祥云县进行按疾病诊断相关组(DRGs)支付方式改革实践进行了回顾分析。结果显示,在政府主导、多方协作之下,祥云县因地制宜制定了支付标准,通过加强信息化建设、完善临床路径、加强监管和考核等措施确保了改革顺利推进,提升了新农合基金使用效率,控制了医疗费用不合理增长。但医保管理机构能力仍有待提高,医疗服务需求激增与医疗资源有限的矛盾亟待解决。This paper retrospective analysis on reform and practice of payment mode according to disease diagnosis related groups（ DRGs） in Xiangyun county. The result showes that under the leading of government and cooperation of multi-departments,Xiangyun county has formulated payment standards according to local conditions. It guarantees the reform boost smoothly through strengthening informatization construction,perfecting clinical pathway,strengthening supervision and assessment. It promotes utilization efficiency of new rural cooperative medical fund,and controls unreasonable growth of medical expenses. But the ability of medical insurance management institutions needs to be improved,and the contradiction between the demand for medical services and the limited medical resources needs to be solved too.

关 键 词：疾病诊断相关组 支付方式改革 

分 类 号：R197.3[医药卫生—卫生事业管理]