关于DRG付费方式改革对医院管理的影响及应对策略研究

On the Impact of DRG Payment Reform on Hospital Management and Coping Strategies

医保支付方式改革是近几年中国医改进入深水区后推出的重要举措。疾病诊断相关分组(DRG)是用于衡量医疗服务质量效率以及医保支付的一个重要工具。本文先从DRGs改革为医院管理及临床科室带来的影响进行分析,随后提出了一系列应对方法,从医院实际出发做好DRGs改革的顶层设计;从HIS系统的优化、建立DRGs管理与结算系统、建立DRGs监管系统三方面实现DRGs管理支撑信息系统的建设;从精细化管理的角度提出财务核算和绩效评价的精细化管理制度等,以期帮助施行DRGs模式的医院能快速适应其带来的影响。

Medical insurance payment reform launched in recent years is of great significance for China’s more thorough medical reform.Diagnosis Related Groups(DRG)plays a critical role in measuring the quality and efficiency of medical services and medical insurance payment.This paper first analyzes the impact of DRGs reform on hospital management and clinical departments,then it makes suggestions for hospitals to adapt to DRGs quickly,including making top design of DRGs reform in accordance with reality,establishing information system to support the management of DRGs through optimizing HIS system and building DRGs management system,settlement system and supervision system,and establishing fine management in financial accounting and performance evaluation and so on.