DRG支付方式改革推动公立医院高质量发展——基于国家试点城市三级医院的案例研究  

DRG payment reform promotes high-quality development of public hospitals:A case study of a tertiary hospital in a national pilot city

作　　者：罗毅[1] 左后娟 陈迎春[2] 朱瑞 陈鑫岚 Luo Yi(Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,P.R.China)

机构地区：[1]华中科技大学同济医学院附属同济医院,湖北武汉430030 [2]华中科技大学同济医学院医药卫生管理学院

出　　处：《中国卫生事业管理》2024年第11期1243-1245,1307,共4页Chinese Health Service Management

基　　金：国家自然科学基金资助项目“市域统筹下DRG/DIP付费与紧密型县域医共体总额预付协同机制研究”(72374076)。

摘　　要：高质量发展已成为新时代公立医院建设的主旋律,在DRG支付方式改革和国考双重挑战下,探索DRG支付方式改革要求下的高质量发展路径,是当前公立医院管理实践的关键。本研究利用朱兰的“质量管理三部曲”,从质量计划、质量控制、质量改进三方面,系统阐释了案例医院在DRG付费驱动下的高质量发展路径。2023年案例医院以“三转变,三提高”为战略导向,通过CMI提升专项行动、MDT团队管理、绩效考核引导、信息化建设以及控制医疗成本等一系列措施,有效提升了全院CMI值,合理控制医疗成本并促进了费用结构的优化,对其他医疗机构的实践具有一定的借鉴意义。High-quality development has become the main theme of public hospital construction in the New Era.Under the dual challenges of DRG payment reform and national examination,exploring a high-quality development path based on the re-quirements of DRG payment reform is the key to current public hospital management practice.By using Jurans"quality manage-ment trilogy",the high-quality development path of case hospital driven by DRG payment was systematically explained from three aspects of quality planning,quality control and quality improvement.In 2023,the sample hospital took"three changes,three improvements"as the strategic orientation,and implemented a series of measures such as CMI promotion special actions,MDT team management,performance appraisal guidance,information construction and medical cost control,which has effectively improved the CMI value of the hospital,reasonably controlled medical costs and promoted the optimization of the cost structure.It can be referred by other medical institutions.

关 键 词：DRG 高质量发展 案例分析 

分 类 号：R1-9[医药卫生—公共卫生与预防医学]