DRG/DIP改革绩效评价指标体系构建及应用  

Construction and Application of Performance Evaluation Index System for DRG/DIP Payment Reform

作　　者：张壮伟 

机构地区：[1]河北省秦皇岛市抚宁区医疗保险中心,秦皇岛066300

出　　处：《中国医疗保险》2025年第2期118-127,共10页China Health Insurance

摘　　要：本文主要针对DRG/DIP支付方式改革的成效评估问题展开深入探讨。通过对国内外相关文献及实践进行整理,形成了涵盖医保基金使用效率、医疗服务质量保障、医疗机构运营效能以及参保人员获益等四个方面的绩效评价标准体系,并以秦皇岛市为案例进行实证研究。研究结果表明,构建科学且合理的绩效评估机制,对推动DRG/DIP支付方式改革具有显著导向价值。据此,本研究提出构建完善的评价标准体系、强化评价机制建设、深化相关配套改革等方面的政策建议,旨在为推动医保支付方式改革提供有益参考。This paper focuses on the effectiveness evaluation of DRG/DIP payment method reform.By summarizing relevant literature and practice at home and abroad,the paper forms a performance evaluation standard system covering the efficiency of medical insurance fund,the quality assurance of medical services,the operation efficiency of medical institutions,and the benefits of insured personnel,and conducts empirical study with Qinhuangdao City as a case.The research indicates that establishing a scientific and reasonable performance evaluation mechanism has significant guiding value for promoting the reform of DRG/DIP payment methods.Based on this,this study proposes policy recommendations for constructing a comprehensive evaluation standard system,strengthening the construction of evaluation mechanism,and deepening reform of supporting measures,which can provide useful references for promoting the reform of medical insurance payment methods.

关 键 词：DRG DIP 支付方式改革 绩效评价 指标体系 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]