我国医保支付方式改革运行逻辑与融合发展  

Operational logic and integrated development of China's medical insurance payment reform

作　　者：陈明波 梁沛枫[2] CHEN Mingbo;LIANG Peifeng(School of Public Health,Ningxia Medical University/Hanbin District First Hospital,Yinchuan,Ningxia Hui Autonomous Region,750004,PRC)

机构地区：[1]宁夏医科大学公共卫生学院/汉滨区第一医院,宁夏回族自治区银川市750004 [2]宁夏回族自治区人民医院/宁夏医科大学附属自治区人民医院,宁夏回族自治区银川市750011

出　　处：《中国医院》2025年第4期22-25,共4页Chinese Hospitals

基　　金：中央引导地方科技发展专项(2023FRD05051)。

摘　　要：医保支付方式改革不仅是顺应新时期医药卫生事业高质量发展的迫切需要,而且是医药卫生体制改革自我完善和发展的过程,更是提高医保基金安全和使用效能的必然要求。DRG和DIP是两种不同的医保支付模式,既有个性又有共性,探索二者融合发展,是当前医保支付方式改革的必然趋势,对于区域医疗服务资源优化配置、医疗保障基金规范化使用、医院管理以及信息化建设等方面具有十分重要的现实意义。The reform of medical insurance payment methods is not only an urgent necessity for promoting high-quality development in the new era of healthcare but also a process of self-improvement and advancement within the medical and healthcare system.Moreover,it is essential for ensuring the security and efficiency of medical insurance funds.DRG and DIP represent two distinct medical insurance payment models,each with unique and common characteristics.Exploring their integrated development has become an inevitable trend in the current reform of medical insurance payment methods.This integration holds significant practical implications for optimizing regional healthcare resource allocation,standardizing the use of medical insurance funds,enhancing hospital management,and advancing healthcare informatization.

关 键 词：医保支付 支付改革 DRG DIP 

分 类 号：R197.3[医药卫生—卫生事业管理]