DIP付费改革对医疗机构经济运行的影响研究——以广州市某三甲医院为例

Study on the Impact of DIP Payment Reform on the Economic Operation of Medical Institutions——Taking a Tertiary Hospital in Guangzhou as an Example

以广州市某三甲医院住院数据为例,深入剖析广州市按病种分值付费在划分病种、设定医疗机构权重系数、建立偏差病例调节机制、制定结算办法等核心环节的做法,对比分析医保支付方式改革前后医疗机构服务能力、服务效率、费用控制、质量监管、基金监管等运行指标的变化,从而分析改革的成效和主要挑战,为调整完善按病种分值付费政策提出建议。

Taking the inpatient data of a hospital in Guangzhou,this paper discussed the impact of DIP(Diagnosis-intervention packet)on the economic operation of medical institution.Core practices of DIP on classifying diseases,setting hospital weight coefficients,formulating settlement methods,establishing supervision&assessment mechanisms were deeply analyzed,changes in the service capabilities,service efficiency,cost control,quality supervision,fund supervision were compared in in medical institutions,in order to put forward the main problems and challenges existing in current reform,and provide suggestions for adjusting and improving the policy of DIP.