我国公立医院医疗服务支付制度改革进展及存在问题探讨

Discussions on the progress and problems of public hospital payment system reforms in China

在梳理我国公立医院医疗服务支付制度历史沿革、主要改革做法及成效的基础上，重点分析改革中存在的支付标准不够科学合理、支付制度改革缺乏系统性和联动性、医务人员参与改革的积极性未能充分调动等问题及深层次的制度原因，进而提出推进我国公立医院医疗服务支付制度改革的政策建议，包括谈判确定支付标准，创新支付方式改革的“组合拳”，逐步推进支付制度改革系统工程，建立支付制度改革激励作用的传动机制。

Based on a description of the evolution, main reform practices and effects of public hospital payment system reforms, this paper focused on analyzing the existing problems found in the reforms. Such problems namely include lack of scientific and reasonable design of payment standards, lack of systemic and coordinated system reforms, and failure to fully mobilize the enthusiasm of medical workers to participate in the reforms, as welt as other underlying causes. Based on such suggestions were put forward to promote public hospital payment system reforms, as negotiation of the payment standard between purchasers and providers, ＂combined approaches＂ in innovation in payment methods, advancing systemic payment system reform, and establishing a transmission mechanism of incentive to the medical personnel.