医保定额预付模式发展研究  

Development of Medical Insurance Fixed Prepayment

作　　者：王乾 田侃 WANG Qian;TIAN Kan(School of Health Economics Management,Nanjing University of Chinese Medicine,Jiangsu Nanjing 210023,China)

机构地区：[1]南京中医药大学卫生经济管理学院,江苏南京210023

出　　处：《中国药物评价》2022年第5期377-380,共4页Chinese Journal of Drug Evaluation

摘　　要：作为医保支付方式的一种,定额预付(DRG)支付模式在降低医疗费用不合理支出、有序优化患者就医结构等方面,发挥着重要作用。本文基于DRG支付方式扩大试点的政策背景,从DRG的技术层、应用层、效果层等维度对我国DRG研究进展进行综述,研究发现我国DRG的扩大试点可通过DRG应用范围、分组机制、收付费、落地实施四个维度上加以完善。As a kind of medical insurance payment,diagnosis related groups(DRG)payment plays an important role in reducing unreasonable expenditure of medical expenses and optimizing the structure of patients′medical treatment.Based on the policy background of DRG,analyse the research progress from the aspects of technology,application and effect,and finds that the expanded pilot of DRG can be improved from the four aspects:application scope,grouping mechanism,payment and implementation.

关 键 词：医保支付 定额预付(DRG)支付方式 疾病诊断相关分组 分组机制 支付标准 

分 类 号：R197.1[医药卫生—卫生事业管理]