河南省息县按病种综合支付改革实践与思考

发布时间：2018-06-28 02:39

本文选题：住院费用 + 按病种付费　；参考：《中国卫生经济》2017年10期

【摘要】：医疗费用快速上涨促使了基于费用控制的支付方式的讨论,按病种付费是当前混合支付的重要选择之一。河南省息县按病种付费经过近10年的实践与探索,逐步形成了以政府为主导的总体购买、以病情为依据的定额支付、以质量为导向的绩效考核运行模式。按病种综合支付改革的核心是基于病情的路径分类与基于路径的质量管理。河南省在系统梳理按病种付费的原理下,结合息县的改革实践,明确了当前按病种综合支付改革的先决条件,探索了医保机构、政府部门、医院和医生职能的支撑与转换,在促进三医联动与分级诊疗的推进中也起到了积极作用。
[Abstract]:The rapid increase in medical costs has prompted the discussion of payment methods based on cost control. Paying by disease is one of the most important options for mixed payment. After nearly 10 years of practice and exploration, Xixian County of Henan Province has gradually formed a performance appraisal operation model, which is led by the government as the overall purchase, based on the illness, and based on the quality. The core of the comprehensive payment reform according to disease type is path-based path classification and path-based quality management. On the basis of systematically combing the principle of paying by disease, and combining the reform practice in Xixian, Henan Province has made clear the preconditions for the reform of comprehensive payment according to disease, and explored the support and transformation of the functions of medical insurance agencies, government departments, hospitals and doctors. It also plays an active role in promoting the three-medical linkage and grading diagnosis and treatment.
【作者单位】：信阳市息县医疗保险管理局;华中科技大学同济医学院医药卫生管理学院;湖北省人文社科重点研究基地农村健康服务研究中心;
【基金】：国家自然科学基金项目(71603088)
【分类号】：R197.1

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