我国按疾病诊断相关分组预付费改革进展及建议  

Progress and implications of the DRG-based prospective payment system(DRG-PPS) reform in China

作　　者：胡广宇[1] 刘婕[2] 付婷辉[3] 刘远立[1] HU Guang-yu LIU Jie FU Ting-hui LIU Yuan-li(School of Public Health, Peking Union Medical College, Beijing 100730, China Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China Beifing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100020, China)

机构地区：[1]北京协和医学院公共卫生学院,北京100730 [2]中国中医科学院西苑医院,北京100091 [3]首都医科大学附属北京妇产医院,北京100020

出　　处：《中国卫生政策研究》2017年第9期32-38,共7页Chinese Journal of Health Policy

基　　金：国家自然科学基金重点项目(71532014)

摘　　要：按疾病诊断相关分组预付费是国际上应用较成熟的一种住院患者医保费用支付方式,2017年我国将选择部分地区开展按疾病诊断相关分组预付费试点。本文从省、市、县层面,对国内按疾病诊断相关分组预付费改革典型地区进行个案分析,总结改革方案设计的特点,比较政策实施的差异,讨论改革的经验和启示。在分析当前改革进展和问题的基础上,提出推进我国按疾病诊断相关分组预付费改革的相关建议。DRG-based prospective payment system （DRG-PPS is one type of mature inpatient care payment mechanisms in most countries and pilot projects would be introduced to China in 2017. This article provides an overview of the previous typical DRG-PPS reform initiatives on provincial, municipal and county level respectively. It also summa- rizes the characteristics of the reform programs, describes the diversities of policy implementation, and discusses the suc- cessful experience and implications of the initiatives. The paper puts forward some suggestions on the upcoming DRG-PPS pilot projects based on the progress and problems of the initiatives, to promote the DRG-PPS reform in China.

关 键 词：医疗改革 疾病诊断相关分组 预付费制度 试点项目 

分 类 号：R197[医药卫生—卫生事业管理]