趋利避害实施总额预付

Seeking Benefits and Avoiding Disadvantages in Global Payment

总额预付是一种利弊均很显著的支付方式。它不但能够降低医疗费用、抑制过度医疗需求，也能导致推诿患者、减少服务数量，甚至影响医疗质量和安全。在实行总额预付过程中如何趋利避害，促进医保与医院的健康发展呢？

Global payment has its advantages and disadvantages. On one hand, it could control the healthcare cost, and suppress the need of over-treatment; on the other hand, it could also result in shuffling patients, cutting down the service volume, and thus compromising health quality and patient safety. The responsibility of capping the global payment lies with the management staff of the hospitals instead of the departments, and it is not practical to dissolve the responsibility again to the departments and individuals.