美国医疗服务价格动态调整机制及启示

The dynamic adjustment mechanism of medical service price in the United States and its implications for China

建立科学合理的医疗服务价格动态调整机制是当前公立医院改革的重点方向,本文深入分析了美国医疗服务价格改革历史、动态调整参与主体和流程以及美国医疗服务价格改革的发展趋势。同时,对我国当前医疗服务价格调整存在的问题进行了剖析,并提出了建立多方参与的医疗服务价格动态调整模式;建立医疗服务项目标化点值体系,加强医保支付标准建设;逐步转变现行按项目支付模式,逐步建立DRGs和按绩效付费机制等政策建议。

The establishment of a scientific and reasonable medical service price dynamic adjustment mecha- nism is the focus of the current reform of public hospitals in China. This paper analyzed the medical service price re- form history in the United States, the price dynamic adjustment of the main body and its process, as well as the de- velopment trend of medical service price reform. At the same time, the existing problems of medical service price adjustment in China were briefly analyzed, and put forward 1 ） the establishment of multi-participant dynamic adjust- ment model; 2） the establishment of the medical service standard value system, strengthening Medicare payment standard construction; 3） and gradually changing the current fee-for-service payment system and establishing DRGs and performance based payment mechanism and other policy recommendations.