某公立三甲医院疾病诊断相关分组付费工作实践  

Practice of Diagnosis Related Groups Based Payment in a Grade-A Tertiary Public Hospital

作　　者：王晨曦 Wang Chenxi(Department of Health Economics,The Eighth Medical Center of Chinese PLA General Hospital,Beijing 100091,China)

机构地区：[1]解放军总医院第八医学中心卫生经济科,北京100091

出　　处：《中国社区医师》2024年第36期164-166,共3页Chinese Community Doctors

摘　　要：在疾病诊断相关分组(DRG)付费支付方式改革背景下,公立医院正在面临“控费、提效、调结构”的大考核。解放军总医院第八医学中心被遴选为执行北京市DRG数据模拟的医疗机构,通过完善组织流程、夯实思想基础、强调人员培训、强化信息化支撑实现了按项目付费到DRG付费的过渡,在保证医疗服务的质量、效率的同时,维护患者、医疗机构、医务工作者的三方利益。医院历经2年的数据模拟实践,使病例组合指数稳定在1.00左右。该文从组织、人才、信息化3个要素入手,总结了解放军总医院第八医学中心DRG付费的工作实践,以期为公立三甲医院推进DRG付费工作提供参考。In the context of the diagnosis related groups(DRG)payment method reform,public hospitals are facing a major as-sessment of"cost control,efficiency improvement,and structural adjustment".The Eighth Medical Center of Chinese PLA General Hospital has been selected as a medical institution to carry out DRG data simulation in Beijing.By improving organizational pro-cesses,consolidating ideological foundations,emphasizing personnel training,and strengthening informatization support,the tran-sition from project-based payment to DRG payment has been achieved.While ensuring the quality and efficiency of medical ser-vices,it also safeguards the interests of patients,medical institutions,and healthcare workers.After nearly two years of data simu-lation practice,the hospital has achieved a stable case mix index(CMI)of approximately 1.00.This article starts with three ele-ments of organization,talent and informatization,summarizes the work practice of DRG payment in the Eighth Medical Center of Chinese PLA General Hospital,aiming to provide reference for Grade-A tertiary public hospitals to promote DRG payment work.

关 键 词：疾病诊断相关分组 付费改革 公立三甲医院 病例组合指数 

分 类 号：R197.322[医药卫生—卫生事业管理]