云南省儿童先心病从单病种付费限价的实践总结

Reflections on Children's Congenital Heart Disease Based on the Ranging from Paying for Single Disease to Limiting Price According to Disease Group

通过对先心病从单病种付费到按病组限价进行回顾及效果分析,总结不同付费方式的成功经验和存在的不足。在制定支付标准时要客观统计分析费用、合理确定分组方法,以保证医院收入不降低并能持续发展;医院应通过绩效改革调动医务人员参与支付方式改革的积极性。

Objective： To discuss the problems that should be paid attention to in the payment mode reform. Methods： By reviewing and analyzing the effect of the congenital heart disease from single disease to limited price, the successful experiences and shortcomings of different payment methods were summarized. Results： In 2010, the children＇s congenital heart disease was paid by single disease, and the effect was not good. The main reason was that there were two kinds of treatment： surgical treatment and medical intervention. The difference in cost was significant when the payment scheme was adjusted at the end of 2013. Since some large hospitals have overrun parts to be borne by the departments themselves, and the balance was partly attributable to the hospitals, during the negotiations, the hospital experts paid less for the cost overruns for the departments,did not agree to the scale fee settlement and adopted the final use of the quota payment. Conclusion： In order to ensure the hospital income did not decrease and develop continuously, the hospital should make use of the performance reform to arouse the enthusiasm of the medical staff to participate in the reform of payment mode.