摘要
目的:本研究旨在探索DIP支付方式与其他医保供给侧政策间的协同效果。方法:以全国DIP改革试点城市A市为处理组,未改革城市B市为对照组进行比较研究。收集2019—2022年共1120个公立医疗机构样本,采用双重差分法对住院医疗总费用及部分费用结构进行分析。结果:A市DIP改革对医疗机构住院医疗总费用、住院检查化验总费用产生显著的抑制效应,对住院药品总费用和住院材料总费用未产生影响。结论:DIP支付方式发挥显著控费效果,住院医疗总费用得到有效控制;单纯采取调价政策与集采政策的控费效果尚有不足;DIP与其他供给侧政策协同,促进医疗费用结构更加合理。建议医保部门注重发挥供给侧政策协同作用,共同推动医保基金使用效率提升。
Objective:This study aims to explore the synergistic effects of DIP and other medical insurance supply-side policies.Method:City A that has piloted DIP reform was set as the treatment group,and City B without reform was set as the control group.A total of 1120 public medical institution samples from 2019 to 2022 were collected.The total medical expenses during hospitalization and some structural expenses were analyzed using DID method.Result:DIP had a significant inhibitory effect on the medical expenses,and the expenses of checkups and examinations during hospitalization in city A,but had no impact on the drug and the material expenses during hospitalization.Conclusion:DIP played a significant cost control role and effectively controlled the total medical expenses during hospitalization.The synergistic effects of price adjustment of medical services policy and national centralized drug/material procurement policy on cost control were insufficient.DIP synergized with other supply-side policies to promote rational medical cost structure.It is suggested that medical insurance departments should focus on the synergistic effects of medical insurance supply-side policies to jointly improve the efficiency of medical insurance fund utilization.
作者
林坤河
上官业声
饶娅琦
彭静
陈翼
姚轶凡
熊英贝
项莉
LIN Kun-he;SHANGGUAN Ye-sheng;RAO Ya-qi;PENG Jing;CHEN Yi;YAO Yi-fan;XIONG Ying-bei;XIANG Li(School of Medicine Health Management of Tongji Medical College of Huazhong University of Science and Technology,Wuhan Hubei 430030,China;Yichang Medical Security Bureau,Yichang Hubei 420500,China;Yichang Medical Security Service Center,Yichang Hubei 420500,China;HUST Base of National Institute of Healthcare Security,Wuhan Hubei 430030,China)
出处
《中国卫生政策研究》
CSCD
北大核心
2024年第5期17-24,共8页
Chinese Journal of Health Policy
基金
国家自然科学基金项目(72174068)
中央高校基本科研业务费专项资金资助项目(YCJJ20242228)。
关键词
DIP支付方式
供给侧改革
医疗服务价格调整
药品/耗材集中采购
DIP payment method
Supply side reform
Price adjustment of medical services policy
National centralized drug/material procurement policy