特需医疗服务定价原则与实施路径探索  

Exploration of Pricing Principles and Implementation Paths for Special Medical Services

作　　者：李小夏 谭中和 

机构地区：[1]广州医科大学附属第一医院,广州510120 [2]中国劳动学会薪酬委员会,北京100000 [3]中国劳动和社会保障科学研究院,北京100000

出　　处：《中国医疗保险》2024年第11期103-109,共7页China Health Insurance

基　　金：广东省会计学会2023-2024年度科研立项课题“构建全面、高效的智慧财务收入管理体系--以广东省某公立医院为例”(20236-13);广东省卫生经济学会2023年度科研立项课题“公立医院预算绩效评价体系构建研究--以A医院为例”(2023-WJMZ-71)。

摘　　要：特需医疗服务的开展是提升医疗资源的使用效率、更好地平衡医疗服务供给和需求、保障人民群众健康权益的需要。经过多年的实践,各地医疗机构逐渐形成了各具地方特色的特需医疗服务项目。但是在实际运行中,由于缺乏规范指引,公立医院对申报条件、定价原则、项目准入、报备程序和实施路径等方面认知不够明晰。特需医疗服务定价存在强调设备硬件投入、轻视专业技术价值等问题,影响项目定价的合理性,项目实施注重内部流程审批,未规范指引如何向当地医保物价部门进行备案,缺乏对特需医疗服务价格的动态监控、调整。本文通过对项目医院开展特需医疗服务的过程梳理,归纳总结特需医疗服务定价原则和实施路径,获得改进公立医院特需医疗服务项目管理的启示。The development of special medical services is necessary to improve the efficiency of medical resource utilization,better balance the supply and demand of medical services,and safeguard the health rights of the people.After years of practice in various medical institutions,special medical service projects with local characteristics have gradually formed.However,in the actual operation,public hospitals lack clear understanding in terms of application conditions,pricing principles,project admission,reporting procedures,and implementation paths for lack of standardized guidelines.There are problems with the pricing of special medical services,such as emphasizing equipment hardware investment and neglecting technical value,which affect the rationality of project pricing.Project implementation focuses on internal process approval,without standardized guidance on how to register with local medical insurance and price departments,and lacks dynamic monitoring and adjustment of special medical service prices.This article summarizes the pricing principles and implementation paths of special medical services by reviewing the process of implementing special medical services in the sample hospital,and provides insights for improving the management of special medical service projects in public hospitals.

关 键 词：特需医疗服务 定价原则 实施路径 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]