北京市单病种付费政策回顾性研究

Retrospective Study of Single Disease Payment Policy in Beijing City

目的回顾分析北京市单病种政策执行情况,为付费制度改革提供建议。方法通过对医院单病种运行指标分析,评价单病种运行现状;选择盈亏的典型病种对照临床路径,探究原因。结果单病种政策有效降低了平均住院日、个人负担、次均费用,部分病种偏离率较高;病种盈亏与政策是否及时调整有关。结论北京市执行单病种政策有效遏制医疗费用不合理增长,但政策长期不调整使医院执行政策走形。建议政府部门通过扩大病种范围、设立定额标准调整规则、配套监管措施,提高医疗质量和控费效果。

Objective To review the implementation of single disease payment policy in Beijing City and provide suggestions for the reform of the payment system. Methods By analyzing the operation indexes of single disease policy in hospital, and evaluating the current operation situation of single disease, the typical pathology of surplus or deficit was selected to explore the reason. Results The single disease policy effectively reduces the average length of stay, personal burden and the average cost. The deviation rate of some diseases is higher. The profit and loss of diseases is related to whether the policy is adjusted in time. Conclusion The implementation of single disease policy in Beijing City effectively curbs the unreasonable growth of medical expenses, but the policy does not adjust the long-term implementation of the policy result in the deformation in hospital. It is suggested that government departments should improve the quality of medical treatment and control the cost by enlarging the scope of diseases, setting up the quota standard adjustment rules and supporting the supervision measures.