国内外DRG实践发展及其对我国的启示  

Development of DRG Practice at Home and Abroad and its Enlightenment to China

作　　者：汤鑫 刘颜 TANG Xin;LIU Yan(School of Public Health,Guilin Medical University,Guilin 541004,Guangxi,China;Medical Records and Statistics Room,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong,China)

机构地区：[1]桂林医学院公共卫生学院,广西桂林541004 [2]北京大学深圳医院病案统计室,广东深圳518036

出　　处：《医学信息》2023年第21期27-30,36,共5页Journal of Medical Information

基　　金：深圳市“三名工程”资助项目(编号:SZSM201812088)。

摘　　要：疾病诊断相关分组(DRG)是医保支付的必然发展方向,其落地实施深刻影响中国的医疗服务保障体系,有利于控制整体的医疗费用,促进医疗机构的发展思想由规模扩展转为提质增效,管理方式由简单化管理转为精细化管理。本文通过研究国外多个实行DRG医保支付制度的具有代表性的国家,借鉴国际经验,分析我国推进DRG的实践进展情况、政策演进状况以及现存问题,提出推进我国DRG发展的科学化建议,为国内的DRG发展提供一定参考。Diagnosis related groups(DRG)is the inevitable development direction of medical insurance payment.It's implementation has a profound impact on China's medical service security system,which is conducive to controlling the overall medical cost,promoting the development of medical institutions from scale expansion to quality and efficiency improvement,and the management mode from meticulous management to fine management.By studying many representative countries that practice DRG medical insurance payment system abroad,this article draws on international experience,analyzes practical progress,policy evolution and existing problems,and puts forward scientific suggestions on advancing DRG's development in our country to provide some reference for its development in our country.

关 键 词：疾病诊断相关分组 精细化管理 医保 

分 类 号：R197.1[医药卫生—卫生事业管理]