疾病诊断相关分组付费制下国际创新卫生技术支付策略及启示  

International innovative health technology payment strategy and enlightenment under diagnosis-related groups payment system

作　　者：胡赛 胡豫[1] 夏家红[1] 孙扬 舒琴 肖涟 徐小兵 徐守荣 姜垚松 辛艳姣 郭金荣 李迪 Hu Sai;Hu Yu;Xia Jiahong;Sun Yang;Shu Qin;Xiao Lian;Xu Xiaobing;Xu Shourong;Jiang Yaosong;Xin Yanjiao;Guo Jinrong;Li Di(Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院,武汉430022

出　　处：《中华医院管理杂志》2021年第3期207-210,共4页Chinese Journal of Hospital Administration

摘　　要：在疾病诊断相关分组(DRG)付费制下,具有较高成本和风险的创新卫生技术可能会在一定程度上受到限制。如何平衡医疗卫生费用的增长和创新卫生技术的发展是当前医保支付方式改革中亟需解决的一个难题。作者通过研究国际上较为成熟的创新卫生技术支付体系,发现各国普遍采取附加支付或额外补偿的方式来鼓励创新卫生技术的发展,但同时也建立了较为完善的卫生技术评估与付费管理机制以保障支付计划的规范运行。国际先进经验做法为我国DRG付费制下的创新卫生技术支付策略提供了参考,建议建立科学合理的创新卫生技术评估机制,同时为短期证据有限的创新卫生技术打造特殊准入通道,并逐步形成DRG付费体系中的创新卫生技术长期激励机制。Under the diagnosis-related groups(DRG)prospective payment system,innovative health technologies with high costs and risks may be limited to some extent.How to balance the increase of health care cost and the development of innovative health technology is a difficult problem to be solved in the current reform.By studying the relatively mature payment systems of innovative health technologies in the world,the authors found that countries generally adopted additional payment or compensation to encourage the development of new technologies.But at the same time,a relatively perfect health technology assessment and payment management mechanism had been established to ensure the standardized operation of payment plan.These international advanced experience and practice could provide references for China′s innovative health technology payment strategy under the DRG payment system.It is suggested to establish a scientific and reasonable assessment mechanism of innovative health technology,create a special access channel for innovative health technology with limited short-term evidence,and gradually form a long-term incentive mechanism of innovative health technology in DRG payment system.

关 键 词：疾病诊断相关分组 创新卫生技术 卫生技术评估 补偿 不均分配 

分 类 号：R197.1[医药卫生—卫生事业管理]