按病种分值付费背景下公立医院医疗行为分析

Analysis of Medical Behavior in Public Hospitals Under the Background of DIP

目的:探索DIP支付方式改革对公立医院医生医疗行为的影响,为医院更好地适应DIP支付方式改革提供建议。方法:采用问卷调查法和专家访谈法了解临床医生对DIP支付方式改革的看法。通过单因素方差分析对心血管内科患者的人均检查费用、人均药品费用以及医院各病区平均住院时长等指标进行分析。结果:临床医生对DIP支付方式改革认同度较高,诊疗行为更加规范,临床科室控费能力进一步提高,患者平均住院时长显著降低。建议:公立医院应增强按病种分值付费理念,加强宣传培训;医保部门应进一步完善DIP支付方式改革,保证分值单价稳定,确保医保基金平稳运行。

Objective: The paper explores the effect of DIP payment mode reform on public hospitals,and provides suggestions for public hospitals to adapt to the DIP payment mode reform. Methods: Questionnaire survey and expert interview were used to understand clinicians’ views on the reform of DIP payment method. The cardiovascular patients’ average cost of examination, average drug cost and average length of stay in each ward were analyzed by one-way analysis of variance. Results: The reform of DIP payment mode was highly recognized by clinicians, the medical treatment behavior was more standardized, the cost control ability of clinical departments was further improved, and the average length of patient stay was significantly reduced. Suggestion: Public hospitals should enhance the understanding, publicity and training of DIP. The medical insurance department should further improve the reform of DIP payment mode to ensure the stability of the unit price and the stable operation of the medical insurance fund.