新支付模式下精准诊疗的探索——冠心病跨学科诊疗

Exploration of precision diagnosis and treatment under DRG payment mode——the multidisciplinary diagnosis and treatment of coronary artery disease

疾病诊断相关分组付费(DRG)支付模式作为中国医保重点改革之一,已在全国各地逐步推行。这势必推动医疗机构“精细化”成本控制和“精准化”诊疗的发展。在保障患者医疗需求的前提下,医疗机构需要积极跨学科整合医疗资源,提高精准诊疗技术,及早诊断,及早治疗,减少及避免疾病发展为重症阶段,同时也避免“经验性治疗”带来的医疗资源浪费。文章试以冠心病跨学科精准诊疗为例,以单光子发射CT核素心肌灌注成像(SPECT MPI)等无创检测方法辅助完善冠心病诊疗为突破口,结合自身经验,就DRG支付模式下的医疗发展方向提出建议。

As a crucial part of China’s medicine and healthcare system reform,the DRG payment mode has been gradually implemented throughout the country. This mode is bound to improve the development of "refined" cost control and "precision" diagnosis and treatment in medical institutions. On the premise of ensuring the medical needs of patients,medical institutions have to actively integrate multidisciplinary medical resources,improve precision diagnosis and treatment technology,put“early diagnosis,early treatment”into practice,reduce or even avoid the disease development,and therefore prevent the waste of medical resources caused by “empirical treatment”. By takeing the case of multidisciplinary precision diagnosis and treatment of coronary heart disease as an example,and the non-invasive detection methods,of SPECT MPI to assist diagnosis and treatment of coronary heart disease as a breakthrough point,and based on our own experience,this paper proposes suggestions on the development direction of medicine under the DRG payment mode.