息县新农合支付制度改革创新的实践启示

The Practical Enlightenment of the Innovation of the New Rural Cooperative Medical System in Xixian County

为配合新一轮医改对提高诊疗质量、控制医疗费用、推进分级诊疗的要求,河南省息县新农合基金管理部门从2011年开始,在世界银行专家组的协助下,从支付手段入手,创新性地提出了按病种病情定额支付与临床路径管理相结合的支付制度改革。几年来,支付制度改革有效地解决了费用控制、医疗质量监管、县乡两级医疗机构的协作医疗、分级诊疗等核心问题,总结了其中的管理创新经验,探讨了存在的问题,并提出了未来支付方式改革的建议。

In line with the new medical reform to improve the quality of care,control medical costs,advance tiered medical service,the fund administration of County Xixian Henna Province with the assistance of the World Bank expert group,means of payment from the start,innovation the proposed reform of the payment system by disease condition fixed payments and the combination of clinical path management,In recent years,effective solution to cost control,quality medical supervision,coordination of county and township levels medical institutions,medical grade core issues,which summed up the group＇s innovation management experience,discuss the existing problems and put forward recommendations for future payment reform.