我国实行DRGs付费机制改革初探

Study on the Implementation of DRGs Payment Reform

随着人民生活水平不断提高,健康需求也随之迅速增加,我国面临医疗费用持续上涨的压力,原有以服务项目为主体的付费方式已经严重阻碍了医疗卫生事业的发展。DRGs作为一种更为合理的医疗费用支付方式,兼顾了政府、医院、患者等多方利益,又达到了医疗质量与费用的合理平衡[1],以DRGs预付机制为主,辅以按项目、服务单元和总额预付等多元支付制度是医保付费的改革方向。

Health needs of the public is increasing rapidly along with the continuous improvement of their living standards. As a result, China is facing the pressure of continuously rising health care costs, and the previous services-centered payment system has seriously hindered the development of medical and health services. As a more reasonable payment method of medical expenses, DRGs has not only taken interests of various parties into account, including the interests of the government, hospitals and patients, but also reached a reasonable balance between the quality and cost of health care. The diverse payment system, which focuses on DRGs prepaid mechanism with the supplementation of prepaid mechanism based on projects, service unit and total amount, is the future of medicare payment reform.