我国医保支付按病种分值付费的发展现状及问题分析  

Analysis of the Current Status and Problems of the Development of the Diagnosis-intervention Packet of China

作　　者：陈竹清 赵明清 程子祎 贾利高 胡春平 刘军安[1] CHEN Zhu-qing;ZHAO Ming-qing;CHENG Zi-yi;JIA Li-gao;HU Chun-ping;LIU Jun-an(School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,430030,China)

机构地区：[1]华中科技大学同济医学院公共卫生学院,湖北武汉430030 [2]湖北省卫生健康委员会,湖北武汉430015 [3]华中科技大学同济医学院附属同济医院,湖北武汉430030

出　　处：《中国初级卫生保健》2023年第4期29-32,共4页Chinese Primary Health Care

基　　金：湖北省卫生健康委资助项目(20211345)。

摘　　要：按病种分值付费(Diagnosis-intervention Packet, DIP)是我国正在推行的一种基于点数测算的医保支付方式,但是DIP支付方式还处于探索期,存在病种覆盖不全、分值确定不合理等问题,因此需要进一步分析探索。文章结合试点地区DIP的实践情况,对DIP的主要环节、发展现状及出现的问题进行梳理,提出完善DIP的相关对策。Payment by disease score is a medical insurance payment method based on point calculation that is being implement⁃ed in China.However,the reform is still in the exploratory period,and there are problems such as incomplete coverage of diseases and unreasonable determination of score,which need further analysis and exploration.Based on the practice of paying by disease in the pilot area,this paper sorts out the main links,development status and problems of paying by disease,and puts forward the rele⁃vant countermeasures of paying according to disease.

关 键 词：按病种分值付费 医保改革 医保支付方式 

分 类 号：R197[医药卫生—卫生事业管理]