基于试点地区医疗服务价格调整机制的思考  

Thoughts on the Price Adjustment Mechanism for Medical Services in Pilot Areas

作　　者：徐伟[1] 何琼 李雯靖 刘萍 周健 XU Wei;HE Qiong;LI Wenjing;LIU Ping;ZHOU Jian(School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing Jiangsu 211198,China;不详)

机构地区：[1]中国药科大学国际医药商学院,江苏南京211198 [2]江苏省卫生健康发展研究中心,国家卫生健康委计划生育药具不良反应监测中心,江苏省生育力保护与卫生技术评估重点实验室,江苏南京210003

出　　处：《卫生经济研究》2024年第1期55-58,共4页

基　　金：江苏省卫生健康发展研究中心开放课题“江苏省DRG付费方式下医疗机构运营策略研究”(JSHD2022004);江苏省科教能力提升工程(ZDXYS202210)。

摘　　要：目的:优化医疗服务价格调整机制,为深入推进医疗服务价格改革提供参考。方法:采用描述性分析,对我国五个试点地区的医疗服务项目调价机制进行梳理。结果:医疗服务项目分类缺乏具体量化指标,调价触发机制不够完善,调价总量指标还需优化,分类定价机制亟需进一步明晰。结论:以“医保患”三方平衡为主旨,优化医疗服务价格调整的主要环节,在群众负担总体稳定、医保基金可承受、公立医疗机构健康发展的基础上,合理调整医疗服务价格。Objective To optimize the price adjustment mechanism for medical services,and to provide reference for deepening the reform of medical service prices.Methods The price adjustment mechanism for medical service projects has been sorted out in five pilot areas of China.Results There were some problems,such as the lack of specific quantitative indicators for the classification of medical service projects,incomplete triggering mechanisms for price adjustment,the need for optimization of the total price adjustment indicators,and the urgent need for further clarification of the classification pricing mechanism.Conclusion It is necessary to prioritize the three-party balance of"medical,insurance and patients",optimize the main the procedures in adjusting medical service prices,and reasonably adjust medical service prices on the basis of overall stability of public burden,affordability of medical insurance funds,and sustainable development of public medical institutions.

关 键 词：医疗服务价格项目 动态调整 分类管理 

分 类 号：R197[医药卫生—卫生事业管理]