建立健全省级医疗服务价格动态调整机制研究——以陕西省西安市19家公立医院为调查样本

Research on Establishing and Improving the Dynamic Adjustment Mechanism of Provincial Medical Service Price——Take 19 public hospitals in Xi’an, Shaanxi Province as survey samples

深化医疗服务价格改革是完善公立医院补偿机制、建立运行新机制的核心内容,对推动卫生健康事业高质量发展、深化供给侧结构性改革具有十分重要的意义。本文立足于陕西19家城市公立医院"十三五"时期运行状况的实证分析,运用国际视野、创新理念、系统思维、数据分析等研究方法,全面系统提出建立健全省级医疗服务价格动态调整机制的目标任务、遵循原则、启动条件、约束指标、成本确定、医院管理等制度设计和政策建议。本文提出以医疗服务成本约束指标作为核心指标,启动动态调整机制时起主导作用。其他综合平衡指标只能作为制衡各方利益的参考值,在制定调价方案时起辅助作用。建议建立医疗服务成本控制体系和多方民主协商机制以及现代医院精细化管理制度,以期为建立简便易行、高效运作的价格动态调整机制提供参考。

Deepening the reform of medical service prices is the core content of improving the compensation mechanism of public hospitals and establishing a new operating mechanism. It is of great significance for promoting the high-quality development of health care and deepening the supply-side structural reform. Based on the empirical analysis of the operating conditions of 19 urban public hospitals in Shaanxi during the 13 th Five-Year Plan period, this article uses international perspectives,innovative ideas, systematic thinking, data analysis and other research methods to comprehensively and systematically propose the establishment and improvement of a provincial-level medical service price dynamic adjustment mechanism System design and policy recommendations such as the objectives and tasks, following principles, starting conditions, constraint indicators, cost determination, and hospital management. This article proposes to take the medical service cost constraint index as the core index to play a leading role when starting the dynamic adjustment mechanism. Other comprehensive balance indicators can only be used as reference values ??to check and balance the interests of all parties and play an auxiliary role in formulating price adjustment plans. It is recommended to establish a medical service cost control system, a multi-party democratic consultation mechanism, and a refined management system for modern hospitals, in order to provide a reference for establishing a simple,easy and efficient dynamic price adjustment mechanism.