支付方式对医疗质量的影响分析

Analysis of Impact of Payment Methods on Medical Quality

目的:了解支付方式对医疗卫生服务质量的影响。方法:文献综述法。结果:理论上支付方式会对医务人员行为构成影响,从而间接影响到医疗服务质量;文献综述显示按项目付费、按人头付费和单病种付费等支付方式对医疗质量有影响,但不同支付方式对医疗质量的影响不同。结论:支付方式确实对医疗服务质量有影响,但支付方式对医疗服务带来的影响是正面还是负面,尚需结合疾病种类和实施条件做出判断。建议:支付方式改革时综合考虑费用控制与医疗服务质量,积极探索混合支付方式。

Objective： This paper aims at understanding the impact of payment methods on medical quality. Methods ： Literature review is used. Results： Theoretically, payment methods will affect the behavior of medical staffs, and affect the quality of medical ser- vices indirectly. Most of literatures retrieved show that payment methods, such as fee for services, capitation and diagnosis related groups have impact on medical quality, but different payment method has different impact on medical quality. Conclusion： Payment methods do have impacts on medical quality, but whether the impact is positive or negative needs to identify with Specific disease and implementing conditions. Suggestions： We should consider the relation ship between cost containment and medical quality improvement during implementing payment reform, and explore mix payment methods actively.