基于价值医疗的病种绩效管理实践与探索

Practice and Exploration of Disease Performance Management Based on Value Medical Care

基于价值医疗理念,在计划环节,根据患者需求,动态调整病种预算,在执行环节强化药品和耗材的使用监管,在评价改善环节不断完善考核与反馈机制,开展以降本增效为核心的病种管理实践。以案例医院膝关节置换术为例,2023年费用控制较好,费用结构进一步优化,且医师组间次均毛利率及次均材料费差异无统计学意义。价值医疗理念为优化病种绩效管理提供了新的视角,推进了病种绩效管理内涵建设,促进了医疗机构业务和财务深度融合,有利于降低患者费用负担,提高服务质量与效率。

Based on the concept of value medical care,according to the needs of patients,the disease budget was dynamically adjusted,the supervision of the use of consumables in the implementation process was strengthened,the assessment and feedback mechanism in the evaluation and improvement process was continuously improve,and the practice of disease management with cost reduction and efficiency improvement as the core was carried out.Taking the knee arthroplasty in the case hospital as an example,the cost control was better in 2023,the cost structure was further optimized,and there was no difference in the average gross profit rate per time and the average material cost per time between the physician groups.The value medical care concept provides a new perspective for optimizing disease performance management,promotes the connotation construction of disease performance management,facilitates the deep integration of business and financial within medical institutions,helps to reduce the financial strain on patients,and improves service quality and efficiency.