医疗服务价格动态调整机制建立、实质性运行及影响  

Establishment,Operation and Influence of Dynamic Adjustment Mechanism for Medical Service Prices

作　　者：郑大喜[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《中国医疗保险》2024年第6期90-98,共9页China Health Insurance

摘　　要：建立医疗服务价格动态调整机制并实质性统筹协调运行,是深化医改的重点任务,事关民生,政策性强、社会关注度高、涉及利益主体多、协同难度大。本文通过系统梳理典型地区医疗服务价格动态调整方案内容与实施进展,分析改革运行效果及对医、保、患各方影响。整体来看,典型地区医疗服务价格动态调整后公立医院总体运行平稳,医院收入结构、患者医疗负担、医保基金支出得到平衡,达到预期目标。为进一步完善医疗服务价格动态调整机制,建议按通用型、复杂型项目分类设置调价触发机制量化评估指标,完善报价规则,合理分配调价空间至选定项目,借助成本价格信息平台监测改革运行、跟踪评估调价效果。Establishing a dynamic adjustment mechanism for medical service prices and substantially coordinating and operating the mechanism is a key task of deepening the medical reform.As a matter of people's livelihood,it is closely related to policies,with high social attention and various stakeholders,which is difficult to coordinate.This paper systematically summarizes the content and implementation progress of dynamic adjustment plans of medical service prices in typical areas,and analyzes the effect of reform and its impact on hospitals,medical insurance and patients.On the whole,after the dynamic adjustment of medical service prices in typical areas,the operation of public hospitals is generally stable,and the income structure of hospitals,the medical burden of patients,and the expenditure of medical insurance funds are balanced,reaching the expected goal.In order to further improve the dynamic adjustment mechanism of medical service prices,it is suggested to set quantitative evaluation indicators of trigger mechanism according to the classification of general and complex items,improve the quotation rules,rationally allocate adjustment space to selected items,and monitor the reform operation,track and evaluate the effect of price adjustment with the help of cost price information platform.

关 键 词：医疗服务价格 动态调整 比价关系 技术劳务价值 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]