医疗保险支付方式改革背景下大型公立医院发展策略

Development strategy of large public hospitals in the context of healthcare payment reform

为保证医疗保险基金的收支平衡,我国启动了基于疾病诊断相关分组(diagnosis related groups,DRGs)的支付方式改革,以解决目前按项目付费模式下医疗费用不合理增长的状况。这一支付方式将彻底改变大型公立医院当前的运营逻辑,并对学科建设和医院发展带来重大影响。通过PEST(政治、经济、社会文化、科学技术)模型分析宏观外部环境变化,有针对性地提出大型公立医院应对基于DRGs的支付方式改革的发展策略。

In order to ensure the balance of payments in medical insurance fund,Chinese government has launched the diagnosis related groups(DRGs)payment reform to curb the unreasonable growth in medical expenses under the current fee-for-service payment.DRGs has the potential to completely change the current operation and development mechanism of large scale public hospitals,and impose a significant impact on discipline construction and hospital development.Based on PEST(politics,economy,society,technology)analysis of the macro external environment evolution,this paper puts forward the development strategy of large public hospitals to cope with DRGs payment reform.