诊断相关分组或诊断-治疗打包支付方式下急性脑梗死诊断与治疗中国专家建议

Chinese experts consensus on diagnosis and treatment of ischemic stroke under diagnosis related groups(DRG)or diagnosis-intervention packet(DIP)payment system

诊断相关分组(diagnosis related groups,DRG)和诊断-治疗打包(diagnosis-intervention packet,DIP)支付方式是落实我国医疗保险支付方式改革的重要举措。缺血性卒中是我国成人致死致残的最主要疾病,如何规范开展DRG/DIP支付方式下的急性脑梗死的诊断与治疗,国内目前尚无共识。中国医师协会神经内科医师分会组织国内相关专家成立编写专家组,参照循证指南的制定方法步骤,调研、收集并整理临床医师及医院医保管理者关注的问题并检索相关文献,结合我国各地医疗机构实际情况制订本专家建议。本专家建议包括DRG和DIP支付方式概况、急性脑梗死规范化诊断和治疗建议、病案首页规范化填写、二级预防和门诊诊断与治疗建议,以及诊断和治疗面临的新问题和对策等多个方面内容,旨在推进指导临床医生在DRG和DIP支付方式下,进一步规范脑梗死的管理,并推进落实医保支付方式改革,最终达到医疗机构提质控费增效、参保患者自费负担降低和医保基金使用效能提升的目的。

Diagnosis related groups(DRG)and diagnosis-intervention packet(DIP)payment are important policies to promote the reform of medical insurance payment mode in China.Ischemic stroke is a major cause of mortality and disability in Chinese adults.There is a lack of consensus on how to manage the acute ischemic stroke under the DRG/DIP payment system.A writing committee was invited by the China Neurologist Association.The panel investigated the concerns of physicians,medical insurance authorities and reviewed relevant literatures under the Levels of evidence algorithm to make recommendations.The expert consensus includes an overview of the DRG/DIP payment system,recommendation of diagnosis and treatment for acute ischemic stroke under the DRG/DIP payment system,qualification of the Front Sheet,secondary prevention and outpatient diagnosis and treatment recommendations,new challenges,and strategies for the future.One goal of the consensus is to provide comprehensive management of ischemic stroke for physicians under the DRG/DIP payment system.The other goals of the consensus are promoting the reform of medical insurance payment,reducing the burden of insured patients,reinforcing quality,controlling the cost of medical institutions,and improving the efficiency of medical insurance funds.