DIP改革赋能三级医疗机构发展内涵的实践与应用研究  

Research on Practice and Application of DIP Reform in Promoting the Connotation Con⁃struction of Tertiary Medical Institutions

作　　者：宋静[1] 徐克平[1] 米灿 刘远泉 SONG Jing;XU Keping;MI Can;LIU Yuanquan(Medical Insurance Office,Huai’an First Hospital Affiliated of Nanjing Medical University,Huai’an,Jiangsu,223300;Fund Settlement Department,Huai'an Social Medical Insurance Fund Management Center,Huaian,Jiang-su,223300)

机构地区：[1]南京医科大学附属淮安第一医院医保处,江苏淮安223300 [2]淮安市社会医疗保险基金管理中心基金结算科,江苏淮安223300

出　　处：《江苏卫生事业管理》2023年第7期875-878,888,共5页Jiangsu Health System Management

基　　金：2021年江苏省医院协会医院管理创新研究课题面上项目(JSYGY-3-2021-403);2021年江苏省医院协会医院管理创新研究课题面上项目(JSYGY-3-2021-186)。

摘　　要：2003年,样本城市开始实行“按病种分值”付费,经过多年不断的发展、完善,对该市医疗机构加强内涵建设起到了一定的促进作用。本研究主要对样本城市DIP改革背景及结算方式进行描述,通过DIP入组情况、辅助目录调整病例占比、病种费用等指标运行情况,总结分析DIP改革给三级医疗机构经济运行、病案管理、学科建设等方面带来的影响与实践应用效果,指出DIP不仅可促进医院加强医疗、医保协同发展,同时可推动医院强化业财融合,提高经济运行效率,提升医院社会效益等。In 2003,the sample city began to implement Payment according to disease classification.After years of development,it promoted the medical organization to strengthen the connotation construction.This study mainly describes the background of DIP re-form and the payment model of medical insurance.Through the proportion entering the DIP disease groups,the rate of cases entering the auxiliary directory,the cost of disease and other indicators,it analyzed the impact and practical application effectof DIP reform on the economic operation,medical record management and discipline construction of tertiary medical institutions.DIP not only promotes the hospital to strengthen the coordinated development of medical treatment and medical insurance,but also strengthens the integration of medical undertakings and finance,improves economic operation efficiency and social benefits.

关 键 词：DIP 医疗机构 内涵建设 

分 类 号：R197.3[医药卫生—卫生事业管理]