国际健康干预分类体系对中医药医保支付的借鉴意义  

Implication of the International Classification of Health Interventions System for TCM Medical Insurance Payment

作　　者：刘冉 高阳 祖亮华[1] 朱哿瑞 窦丹波[2] 桑珍[2] LIU Ran;GAO Yang;ZU Liang-hua(International Institute for Standardization of Traditional Chinese Medicine,Shanghai University of Tra Chinese Medicine,Shanghai,201203,China;不详)

机构地区：[1]上海中医药大学中医药国际标准化研究所,上海201203 [2]上海中医药大学附属曙光医院临床标准化研究所,上海201203

出　　处：《中国卫生经济》2023年第6期1-4,共4页Chinese Health Economics

基　　金：上海市进一步加快中医药传承创新发展三年行动计划(2021—2023年)[ZY(2021-2023)-0213]。

摘　　要：现阶段以按病种分值付费及按疾病诊断相关分组的医保支付改革正如火如荼地进行。中医药诊疗信息平台不完善、优势病种少、临床路径不规范、中医服务价值低等问题成为中医药医保支付改革的突出矛盾。国际健康干预分类是世界卫生组织研制的用于操作编码的统计系统,旨在为各国提供一套标准的用于健康干预统计、医保支付的信息平台。其完善的分类体系可以为中医药医保支付提供完善的干预信息平台,也将为中医药临床路径的制定、优势病种的遴选、价值的核定提供可靠依据。At present,the reform of medical insurance payment based on Diagnosis-Intervention Packet and Diagnosis Related Groups is in full swing.The problems of imperfect diagnosis and treatment information platform,few dominant diseases,irregular clinical pathways,and low service value of traditional Chinese medicine(TCM)have become prominent contradictions in the reform of medical insurance payment of TCM.The International Classification of Health Interventions(ICHI)is a statistical system developed by the WHO for operational coding,which aims to provide countries with a set of standard information platforms for health intervention statistics and medical insurance payment.The perfect classification system may provide a perfect intervention information platform for TCM medical insurance payment,and also provide a reliable basis for the formulation of TCM clinical pathways,the selection of dominant diseases and the evaluation of value.

关 键 词：国际健康干预分类 中医药医保支付改革 中医药干预信息 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R197