医疗服务价格动态调整触发评估指标、规则比较与启示

Comparison and Enlightenment of Trigger Evaluation Indexes and Rules for Dynamic Adjustment of Medical Service Price

目的:梳理国家层面医疗服务价格动态调整政策,比较各地价格动态调整实施方案,归纳各地触发评估共性指标、公立医院参与调价规则。方法:利用文献研究法、比较分析法,回顾国家和地方层面医疗服务价格动态调整政策文件,比较触发评估指标和规则。结果:各省份医疗服务价格动态调整实施方案的触发机制历经定性触发、半定性半定量触发、定量触发三个发展阶段,多数省份尚未设置公立医院报价规则。结论:对于医疗服务价格动态调整机制尚不健全,未实质性启动医疗服务价格动态调整的省份,可根据医疗服务项目特点,分类设立量化触发评估指标;设置复杂型医疗服务报价要求和产生政府指导价规则;合理测算项目成本,作为公立医院报价基础;考虑经济发展状况,平衡好本地价格与周边价格水平。

Objective:The paper summarizes policies for dynamic adjustment of medical service price at the national level,compares the implementation plans of dynamic price adjustment in different regions,and analyzes the common indexes of triggering evaluation and the rules of public hospitals participating in the price adjustment.Methods:By literature research and comparative analysis,the paper reviews the policy documents on dynamic adjustment of medical service prices at the national and local levels,and compares the trigger evaluation indicators and rules.Results:The trigger mechanism of the implementation plan of dynamic adjustment of medical service price in various provinces has gone through three stages of development,i.e.qualitative trigger,half-qualitative and half-quantitative trigger,and quantitative trigger.Most provinces have not yet set up quotation rules for public hospitals.Conclusions:For those provinces where the mechanism of medical service price dynamic adjustment is not yet complete and the dynamic adjustment of medical service price has not been substantially executed,quantitative trigger evaluation indexes can be set up according to the characteristics of medical service projects.Meanwhile,we should set complex medical service quotation requirements and produce government’s guiding price rules,calculate item cost reasonably and take the cost as the basis of public hospital quotation,consider the economic development situation and balance the local price level with the price level in surrounding areas.