DRG支付费率调整系数设计的国际经验  

International Experience in DRG Payment Rate Adjustment Factor Design

作　　者：刘皓冉 王婷[2] 周吴平 简伟研[2] 

机构地区：[1]北京大学公共卫生学院卫生政策与管理学系,北京100191 [2]北京大学公共卫生学院,北京100191

出　　处：《中国医疗保险》2023年第1期122-126,共5页China Health Insurance

摘　　要：DRG支付已经成为全球医疗卫生体系支付方式改革的热门方式,但是部分医疗机构具有与其他医疗机构不同的特征,从而具有更高的成本差异,在DRG付费方式下面临更高的亏损风险。因此,具有不同成本特征的医院共享DRG费率并不合适,一些国家开始探索调整DRG费率。本文总结和比较了美国、澳大利亚、德国等国家和地区调整DRG费率的方法,梳理和总结了调节DRG费率时关注的因素,为我国完善DRG付费制度提供参考。DRG payment has become a popular method of payment reform in global health system. But some medical institutions have different characteristics from other medical institutions, and have higher cost variance, so they face higher risk of loss under DRG payment mode. Therefore, it is not appropriate for hospitals with different cost characteristics to share DRG rates, and some countries have begun to explore adjusting DRG rates. This paper summarizes and compares the methods of adjusting DRG rates in the United States, Australia, Germany and other countries and regions, and the factors concerned when adjusting DRG rates, to provide reference for perfecting DRG payment system in China.

关 键 词：疾病诊断相关组(DRG) 费率 调节系数 国际经验 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]