DIP付费对医疗服务项目诊疗强度的影响研究  

Study on the Impact of DIP Payment on Diagnosis and Treatment Intensity of Medical Service Programs

作　　者：张爱玲[1] 谭华伟 ZHANG Ailing;TAN Huawei(Chongqing Hospital Cost Management Research Center,Chongqing 400700,China;不详)

机构地区：[1]烟台市烟台山医院,山东烟台264003 [2]重庆市医院成本管理研究中心,重庆400700

出　　处：《卫生经济研究》2024年第7期41-43,48,共4页

基　　金：重庆市社科联规划项目“DRG预付制下不同公立医院成本补偿和医疗行为的比较”(2020YBGL98)。

摘　　要：目的:探索DIP付费对医疗服务项目诊疗强度的影响。方法:收集某市2020年1月至2022年12月330家医疗机构住院患者开展数字化摄影诊疗的数据,利用独立样本t检验比较诊疗强度的变化,采用间断时间序列分析考察DIP付费对诊疗强度的影响。结果:DIP付费后三级医院、一级医院数字化摄影诊疗强度分别增加了0.03和0.04,二级医院下降了0.06;三级医院诊疗强度在短期内增加(β_(2)=0.061),长期却呈现下降趋势(β_(3)=-0.007)。结论:DIP付费对医疗服务项目诊疗强度的政策效应可能与政策预期不一致,异质性和同质性并存;要强化DIP支付方式改革与医疗服务价格改革的协同路径。Objective To explore the impact of DIP payment on diagnosis and treatment intensity of medical service programs.Methods The data on digital photography diagnosis and treatment of hospitalized patients in 330 medical institutions in a city from January 2020 to December 2022 were collected.Independent sample t-test was used to compare the changes of diagnosis and treatment intensity,and interrupted time series analysis was used to examine the impact of DIP payment on diagnosis and treatment intensity.Results After DIP payment,the intensity of digital photography consultations increased by 0.03 and 0.04 in tertiary and primary hospitals,respectively,and decreased by 0.06 in secondary hospitals.The intensity of diagnosis and treatment in tertiary hospitals increased in the short term(β_(2)=0.061),but it showed a decreasing trend in the long term(β_(3)=-0.007).Conclusion The policy effect of DIP payment on the diagnosis and treatment intensity of medical service programs may be inconsistent with the policy expectation,and heterogeneity and homogeneity coexist.It is necessary to strengthen the synergistic path between the reform of the DIP payment method and the reform of medical service price.

关 键 词：DIP 数字化摄影 诊疗强度 政策效应 

分 类 号：R19[医药卫生—卫生事业管理]