DIP付费改革对医疗机构经济运行的影响研究——以广州市某三甲医院为例  

Study on the Impact of DIP Payment Reform on the Economic Operation of Medical Institutions——Taking a Tertiary Hospital in Guangzhou as an Example

作　　者：刘敬[1] 陈运山 顾雪非 向国春 LIU Jing;CHEN Yunshan;GU Xuefei;XIANG Guochun(Guangzhou First People's Hospital,Guangzhou Guangdong 510180,China;不详)

机构地区：[1]广州市第一人民医院,广东广州510180 [2]广州市妇女儿童医疗中心,广东广州510620 [3]国家卫生健康委卫生发展研究中心,北京100191 [4]南方医科大学卫生管理学院,广东广州510515

出　　处：《卫生经济研究》2022年第12期29-33,共5页

基　　金：2019年度广东省哲学社会科学规划项目(GD19CGL37);广东省卫生经济学会资助项目(2022-WJMZ-12);国家卫生健康委卫生发展研究中心委托项目“医保支付方式对医疗机构经济运行的影响研究”。

摘　　要：以广州市某三甲医院住院数据为例,深入剖析广州市按病种分值付费在划分病种、设定医疗机构权重系数、建立偏差病例调节机制、制定结算办法等核心环节的做法,对比分析医保支付方式改革前后医疗机构服务能力、服务效率、费用控制、质量监管、基金监管等运行指标的变化,从而分析改革的成效和主要挑战,为调整完善按病种分值付费政策提出建议。Taking the inpatient data of a hospital in Guangzhou,this paper discussed the impact of DIP(Diagnosis-intervention packet)on the economic operation of medical institution.Core practices of DIP on classifying diseases,setting hospital weight coefficients,formulating settlement methods,establishing supervision&assessment mechanisms were deeply analyzed,changes in the service capabilities,service efficiency,cost control,quality supervision,fund supervision were compared in in medical institutions,in order to put forward the main problems and challenges existing in current reform,and provide suggestions for adjusting and improving the policy of DIP.

关 键 词：按病种分值付费 医疗机构 经济运行 

分 类 号：F840.684[经济管理—保险] R197.322[医药卫生—卫生事业管理]