南京市DRG点数法付费在中医院管理中的实践及思考  

The exploration and practice of DRG point payment in the management of traditional Chinese medicine hospitals in Nanjing

作　　者：李静[1] 张晓琴[1] 陈友娴[1] LI Jing;ZHANG Xiao-qin;CHEN You-xian(Jiangsu Provincial Hospital of TCM,Nanjing Jiangsu 210029,China)

机构地区：[1]江苏省中医院,江苏南京210029

出　　处：《卫生软科学》2022年第9期6-10,共5页Soft Science of Health

基　　金：江苏省卫生职业院校文化建设课题重点项目(JCZ202011)。

摘　　要：利用DRG点数法付费的内涵思路,以南京市为例,探讨中医院应对DRG点数法付费面临的挑战和机遇,发现南京市中医院面临了入组、编码、量化、质控等挑战,需要进一步完善中医基础编码、挖掘中医优势病种、优化中医DRG考核体系、探索中医病种日间病房管理模式、重视与医保的良性协商谈判机制,建立真正具有中医特色的DRG点数法付费方式。To explore the challenges and opportunities of DRG point payment in traditional Chinese medicine(TCM)hospitals in Nanjing by the connotation ideas of DRG point payment.It finds that the challenges faced by TCM hospitals in dealing with group enter,coding,quantization and quality control.It is necessary to improve the basic coding of TCM,explore the dominant diseases of TCM,optimize the DRG assessment system of TCM,and explore day ward management model for TCM diseases,pay more attention to benign negotiation mechanism,and establish a DRG point payment method with the characteristics of TCM.

关 键 词：DRG 点数法付费 中医院 南京市 

分 类 号：R197[医药卫生—卫生事业管理]