贵州省中医优势病种支付方式改革推行的影响因素研究  

Study on the Influencing Factors of the Implementation of Payment Reform for Dominant Diseases of Traditional Chinese Medicine in Guizhou Province

作　　者：李祖兰 周戈耀 毛佳 周先凤 LIZulan;ZHOU Geyao;MAO Jia;ZHOU Xianfeng(Research Center of Medical Economy Management,School of Medicine and Health Management,Guizhou Medical University,Guiyang Guizhou 550025,China)

机构地区：[1]贵州医科大学医药卫生管理学院/医药经济管理研究中心,贵州贵阳550025

出　　处：《卫生经济研究》2023年第10期61-65,共5页

基　　金：贵州省医疗保障局委托课题“贵州省中医药适宜技术和优势病种支付方式改革试点工作”。

摘　　要：目的:调查分析贵州省中医优势病种支付方式改革现状及影响因素。方法:采用简单随机抽样法,对改革试点医院相关人员进行问卷调查,运用多因素非条件Logistic回归分析影响改革推行的因素。结果:医院级别、当前遴选的优势病种合理性、改革实施后绩效变化、医生病历书写不规范导致入组错误、医院或医务人员不够重视、中医疾病编码规则,是改革推行的显著影响因素。结论:重视各级医院改革实施差异,遴选更多能够体现医务人员技术劳务价值的优势病种,构建适宜的优势病种遴选评价标准,规范病案首页书写,重视改革实施和监管力度,促进中医优势病种支付方式改革的推广实施。Objective To investigate and analyze the current situation and influencing factors of payment reform for dominant diseases of traditional Chinese medicine in Guizhou province.Methods A simple random sampling method was used to conduct a questionnaire survey on relevant medical personnel in pilot hospitals for reform,and multiple factor unconditional logistic regression analysis was used to analyze the factors influencing the implementation of the reform.Results The hospital level,the rationality of the currently selected dominant diseases,changes in performance after the implementation of the reform,errors in enrollment caused by non-standard medical record writing by doctors,insufficient attention from hospitals or medical personnel,and the coding rules of traditional Chinese medicine diseases were significant influencing factors for the implementation of the reform.Conclusion It is necessary to pay attention to the differences in the implementation of the reform in hospitals at all levels,select more dominant diseases that can reflect the technical labor value of medical personnel,establish appropriate evaluation standards for the selection of dominant diseases,standardize the writing of the first page of medical records,attach importance to the implementation of reform and supervision,and promote payment reform for dominant diseases of traditional Chinese medicine.

关 键 词：医保支付方式改革 中医优势病种 影响因素 

分 类 号：R197.1[医药卫生—卫生事业管理]