调价总量确定与分配:医疗服务价格改革国家试点城市实践经验  

The Determination and Allocation of Total Amount for Price Adjustment:Experience of National Pilot Cities for Medical Service Price Reform

作　　者：梁慧筠 刘倩[2] 吴毅 

机构地区：[1]佛山市医疗保障局,佛山528200 [2]华南理工大学附属第六医院,佛山528200

出　　处：《中国医疗保险》2024年第10期78-84,共7页China Health Insurance

摘　　要：目的:本研究旨在归纳医疗服务价格改革国家试点城市的实践经验,为后续试点地区确定总量测算方法,探索科学分配方案提供建议。方法:本文以厘清调价总量测算方法的逻辑为切口,全面梳理试点城市在总量确定与分配方面的创新做法,并分析其实际应用中遇到的问题。结果:试点城市遵循医疗服务价格改革的政策框架,已探索出适应本地实际情况的总量调控运行模式。结论:建议后续试点地区借鉴试点城市可复制、可推广的经验,以深化医疗服务价格改革为目标,充分利用基线调查结果,科学、合理行使自由裁量权,建立可持续的总量调控机制。Objective:The purpose of this study is to sum up the experience of the national pilot cities of medical service price reform,and to provide suggestions for the following pilot areas to determine the total measurement method and explore the scientific allocation scheme.Methods:This paper clarifies the logic of the calculation method of the total amount of price adjustment,systematically summarizes the innovation highlights of the determination and distribution of the total amount of pilot cities,and analyzes the problems in the application.Results:Following the policy framework of medical service price reform,the pilot cities have explored the operation mode of gross regulation and control to adapt to the local actual situation.Conclusion:It is suggested that the following pilot areas should learn from the experience of the pilot cities that can be replicated and extended,with the goal of deepening the reform of medical service prices,make full use of the results of the baseline survey,and exercise the discretion in a scientific and reasonable mannerto establish a sustainable total amount control mechanism.

关 键 词：医疗服务价格 调价总量 调价总量分配 宏观调控 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]