公立医院视角下构建医疗服务项目成本定价机制探讨  

Discussion on the Cost Pricing Mechanism of Medical Service Projects from the Perspective of Public Hospitals

作　　者：吕侯霞 张媚[1] LüHouxia;Zhang Mei(Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan,610000,China;Medical Insurance Price Office,Renshou County People's Hospital,Meishan,Sichuan,620000,China;不详)

机构地区：[1]成都中医药大学,四川成都610000 [2]四川省眉山市仁寿县人民医院医保物价办,四川眉山620000

出　　处：《中国卫生经济》2025年第1期50-54,共5页Chinese Health Economics

摘　　要：目的:从公立医院视角出发,旨在构建科学合理的医疗服务项目成本定价机制,进而推进医疗服务价格改革。方法:通过回顾两个以技术劳务价值为导向的成本定价方法,强调技术难度和风险程度对建立医疗服务项目成本定价机制的价值。基于《全国医疗服务项目技术规范(2023版)》,收集了9个医疗服务项目的成本数据,采用经过优化的两个定价模型进行定价测算,通过实证研究对比分析两种定价模型的差异。结果:基于运营风险的价值定价法模型更具推广性,人力成本调整系数是定价机制的核心要素,直接影响医护人员技术劳务价值的体现。结论:建议从国家层面推进《全国医疗服务项目技术规范(2023版)》落地,明确技术规范与收费目录对应关系;强化卫生健康部门推动医疗机构成本核算的主体责任,促进成本信息有效应用于医保改革工作;公立医疗机构则应夯实成本信息基础建设,为医疗服务定价提供准确依据,提升定价谈判能力。Objective:From the perspective of public hospital,to establish a scientific and reasonable cost pricing mechanism for medical service items in order to promote the reform of medical service price.Methods:By reviewing two cost-pricing approaches oriented to the value of skilled labor, it emphasizes the value of technical difficulty and level of risk in establishing a cost-pricing mechanism for healthcare service lines. Based on The Technical Specifications for National Medical Service Projects(Version 2023),the empirical analysis was used to calculate the pricing of 9 medical service projects with two optimized pricing models and compare the differences.Results:The value pricing model based on operational risk is more popular. The labor cost adjustment factor is a core element of the pricing mechanism and directly affects the value of the skilled labor of health care workers.Conclusion:It is suggested to promote the implementation of The Technical Specifications for National Medical Service Projects(Version 2023), clarity it relationship between the technology standard and charging items;strengthen the main responsibility of medical insurance department to promote the cost accounting of medical institutions,and promoting the Effective Use of Cost Information in Health care reform efforts. Public medical institutions should consolidate their cost information infrastructure to provide an accurate basis for pricing medical services and enhance their pricing negotiation capacity.

关 键 词：医疗服务项目 成本定价机制 成本核算 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R197