中医优势病种DIP付费对公立中医院运营的影响  

Influence of DIP for TCM Dominant Diseases on the Operation of Public TCM Hospitals

作　　者：蔡淑慧 徐明珍 杜飒[2] 莫曼君[2] 李金燕 范阳东 

机构地区：[1]广州中医药大学第四临床医学院,广州511400 [2]深圳市中医院,深圳518000 [3]广州医科大学卫生管理学院,广州511436

出　　处：《中国医疗保险》2022年第12期78-81,共4页China Health Insurance

基　　金：广东省哲学社会科学规划项目2022年度常规项目(GD22CYJ27)。

摘　　要：目的:分析深圳市将中医优势病种纳入按病种分值付费(DIP)后,中医优势病种对公立中医医院运营的影响。方法:以某三甲公立中医医院2020年-2021年DIP住院病历为研究样本,分析四大类病种组的基本情况及中医优势病种的实施情况,采用描述性统计对中医优势病种进行同病不同组分析。结果:中医优势病种费用管理效果良好,医院收支平衡,略有结余,但也存在医生积极性不高、支付方式未体现门诊中医优势病种等问题。结论:中医医院应把握中医优势病种,提高核心竞争力,将支付方式改革与医生绩效考核挂钩,坚持中西医“同病同效同价”,按疗效价值付费。Objective:This paper analyzes the influence of dominant diseases of traditional Chinese medicine(TCM)on the operation of public TCM hospitals after Shenzhen has incorporated them into the Diagnosis-Intervention Packet(DIP).Methods:Taking the medical records of DIP inpatients from 2020 to 2021 in a 3A public hospital of TCM as the research sample,this paper analyzes the basic situation of four categories of diseases and the implementation of the dominant diseases of TCM.Descriptive statistics is used to analyze the dominant diseases of TCM in different groups.Results:The cost management effect of the dominant diseases of TCM is good,and the hospital's revenue and expenditure is balanced,with a slight balance.However,there are also problems,for example,doctors are not motivated,and the payment method does not reflect the dominant diseases of outpatient TCM.Conclusion:TCM hospitals should enhance the dominant diseases of TCM and improve competitiveness.Medical insurance payment reform should be in line with the performance appraisal of doctors,adhere to the"same disease,same effect and same price"of Chinese and western medicine,and move towards paying according to curative therapeutic effect.

关 键 词：按病种分值付费 中医优势病种 公立中医医院 运营 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]