病种点数法对公立医院分级诊疗的影响  

Influence of Medical Service Point Payment on Public Hospital Hierarchical System

作　　者：莫曼君 MO Man-jun(Shenzhen Hospital of Traditional Chinese Medicine)

机构地区：[1]深圳市中医院

出　　处：《医院管理论坛》2021年第7期29-31,共3页Hospital Management Forum

摘　　要：医改政策是一项关系到民生发展的重要国家性政策,可谓牵一发而动全身,在各地改革面临多重阻力,如何在完善既有政策基础上,优化指标,保证参保人员、公立医院及其服务人员、医疗保险机构三方利益成为了政策改革的首要问题。病种点数法是医保推进的优化新政策,虽实践有些许纰漏,但诊疗分流效果初显。本文将以医保支付视角审视病种点数法当前推进中存在的问题,提出优化建议,以促进我国医疗资源合理分配,缓解看病难、看病贵的问题。Medical reform policy is an important national policy concerning the development of people's livelihood with wide-ranging implications,which meets multiple obstacles across China.How to optimize the formulation of indicators on the basis of perfecting the existing policies,and ensure the interests of the beneficiaries,public hospitals and their staff,medical insurance institutions has become the primary issue of policy reform.The medical service point payment is the new policy of medical insurance,and its effect in dispersing the patients begins to show although it has some defects in practice.This paper looked at the existing problems of the medical service point payment from the perspective of medical insurance payment,and put forward some optimization opinions,aiming at promoting the rational allocation of medical resources in China,and alleviating the problem of difficulty in access to and unaffordability of medical services.

关 键 词：公立医院 分级诊疗 病种点数法付费 医保支付 

分 类 号：R197.4[医药卫生—卫生事业管理]