成都市按病种定额付费制度实施的效果评估——基于成都市某医院住院患者样本的分析

Empirical Study on the Impact of DRG on the Medical Expenditure in Chengdu

目的:基于成都市按病种定额付费制度的试点情况,评估按病种定额付费对降低医疗费用的效果。方法:采用某医院2011-2013年的住院患者就诊样本数据,通过建立三重差分模型对成都市实施效果进行实证研究。结果:成都市定额付费政策对总体医疗费用存在一定影响,但效果有限。结论:导致按病种付费实施效果有限的原因可能与配套政策的缺乏有关,通过按病种定额付费制度以达到约束过度医疗尚需相关政策的支持和完整的运作体系。

The Chinese Health Service Management. Abstract Objective To evaluate the impact of the DRG policy which has been launched as a pilot project in Chengdu in 2011. Methods Literature analysis was used to evaluate the impact of the policy on a national scale, and Triple-Difference model and empirical studies based on the data collected from the in-patient department in a hospital were used to evaluate the impact in Chengdu. Results The DRG policy in Chengdu has a limited impact on the per capita total medical expenditure. Conclusion The lack of supporting policies may causes the limited impact, and DRGs in China need supporting policies and a well-developed imple- mentation system.