建立符合中医药服务运行特点的中医医院补偿机制

To build a compensation mechanism of TCM hospitals according to the characteristics of operation

本文分析了中医医院经济运行特点,与综合医院相比,中医医院诊疗服务依赖于医务人员的知识和经验,对检查、化验设备利用较少;药品服务成本高、损耗大,收入结构中药占比高;医疗服务价格偏低,治疗同一种疾病与西医治疗手法相比次均费用低。根据这些特点,部分省市探索采用基于编制人数、服务量或绩效考核结果等增加中医医院财政投入,调整医疗服务价格,扩大中医药服务报销范围和比例等方式完善中医医院补偿机制。通过比较这些改革措施的优劣及其带来的效果,提出了通过价格调整增强中医医院自偿能力;提高医保总额预付总额和支付比例,加快按病种付费进程;提高中医的财政投入比例等政策建议。

The characteristics of economic operation of Traditional Chinese Medicine （TCM） was figured in this paper. Compared with general hospitals, the TCM services largely relied on the knowledge of medical staff, less depended on the use of inspection and testing equipments; the cost and loss of pharmaceutical services were higher, the proportion of drug income was greater; and the price of medical service was not adequate, and the medical spending was lower when treating the same kind of disease. According to these characteristics, some provinces and municipalities explored ways to improve the compensation mechanism of TCM hospitals, including increasing financial subsidy based on the size of authorized employee, the amount of services or the performance; adjusting the price of TCM medical services, expanding the scope and rate of reimbursement of TCM services. By comparing the pros and cons of the reform measures mentioned above and the effects thus produced, policy recommendations were put forwarded： To enhance the self-financed ability of TCM hospitals through adjusting of medical service price. To increase the amount of global budget for TCM hospitals and payment rate for TCM services, and to accelerate the implement of DRGs pay- ment. To raise the financial subsidy base on performance.