基于RBRVS与DRGs视角的按病种付费模式探讨

Discussion on the Disease-based Payment Model based on the Perspective of RBRVS and DRGs

对RBRVS、DRGs和按病种付费三者之间的关系进行探讨,对按病种付费模式给出建议。方法:采用文献研究法对RBRVS和DRGs的关键构成和计算方式进行梳理。结果:我国的按病种付费存在以成本代替费用、各类成本统一处理、较难区分病种难度和风险的缺陷。结论:RBRVS和DRGs系统中人力成本与非人力成本分类处理、设置难度系数和风险系数等,对我国按病种付费模式具有借鉴意义。

This paper discussed the relationship among RBRVS,DRGs and disease-based payment,and gave advice on disease-based payment.Methods:The key components and calculation methods of RBRVS and DRGs were sorted by literature research method.Results:China's disease-based payment has problems including replacing fees with costs,unified treatment of different kinds of costs,and difficulties in distinguishing diseases and risks.Conclusion:The classification of labor costs and non-labor costs and setting difficulty coefficient and risk coefficients in RBRVS and DRGs system are useful for China's disease-based payment model.