常州市DRGs付费改革实践与成效分析

Practice and Effectiveness Analysis of DRGs Payment Reform in Changzhou

目的:探索常州市DRGs付费改革试点实践的效果,为扩大改革范围积累试点经验。方法:分析16家试点医院改革前一年和改革后前三季度的数据,从费用管理、住院效率、优势病组住院负担等方面初步评估常州市DRGs改革成效。结果:DRGs付费改革对医疗机构和减轻患者负担都带来了积极影响,医方、患方均获得了改革红利。结论:常州市DRGs改革实践探索建立了适宜于本地域的医保管控体系,改革初见成效,其试点经验可供国内DRGs试点城市参考。

Objective:To explore the effect of DRGs payment reform practice in Changzhou and accumulate pilot experience for expanding the scope of reform.Methods:The data of 16 pilot hospitals in the year beforethe reform and first three quarters after the reform were collected and analyzed,and research the effectiveness of DRGs reformin Changzhou from the aspects of cost management,hospitalization efficiency,hospitalization burden of dominant disease groups,etc.Results:It was found that DRGs payment reform had a positive impact on medical institutions and reducing the burden on patients,and hospitals and patients all got the reform dividend.Conclusion:Changzhou CHS-DRGs reform has explored a medical insurance fund management and control system suitable for the local area,and the reform already makes the preliminary effects.Its pilot experience is worth using for referencein domesticDRGs pilot cities.