新型农村合作医疗以病例组合为基础的病种付费设计原理与方法

Designing Principles and Methods of Casemix -Based Episode Payment System under New Rural Cooperative Medical Scheme

随着新农合支付制度改革的不断深入,各地在住院按病种付费上开展了有益的尝试。文章以中部某县为案例研究对象,借鉴国际经验分析探讨以病例组合为基础的病种付费分组原理、定价方法、监管措施建设,为住院按病种付费改革设计实施提供有益借鉴。

With the development of payment system reform for New Rural Cooperative Medical Scheme, inpatient case-based payment reform had been exploring in local counties. Based on the case study of one county in central China and synthesis of international evidences and experiences, to introduce the disease grouping principles, the cost calculating method, and the control measures of case-based payment mechanism by case-mix and provide significant lessons for other counties＇ design and implementation of inpatient case-based payment reform.