政策工具视角下DRG付费改革政策文本量化分析

Quantitative Analysis of the Policies on the DRG Payment Reform from the Perspective of Policy Tools

目的:分析DRG付费改革政策的使用情况,为政策调整与优化提供参考。方法:基于政策工具视角,构建DRG付费改革政策工具-利益相关者的二维分析框架,对政策文本进行梳理、编码。结果:2015—2022年国家层面的DRG付费改革政策文件共87份,政策条目编码156条;供给型、需求型、环境型政策工具分别占49.36%、28.21%、22.44%。结论:我国DRG付费改革政策发文的权威性有待提升,内部次级条目尚需优化;在政策工具设计中,可以发挥医疗机构的主观能动性,适当增加激励性政策工具。

Objective To analyze the use of the policies on DRG payment reform,so as to provide reference for the adjustment and optimization for the policies.Methods From the perspective of policy tools,a two-dimensional analysis framework of DRG payment reform policy tools-stakeholders was constructed to sort out and code policy texts.Results A total of 87 national DRG payment reform policy documents were collected from 2015 to 2022,with 156 policy items encoded.Supply oriented policy tools,demand oriented policy tools,and environmental oriented policy tools accounted for 49.36%,28.21%,and 22.44%,respectively.Conclusion The authority of the policies on the DRG payment reform needs to be improved,and internal secondary items need to be optimized.In the design of policy tools,medical institutions should use their initiative and incentive policy tools should be increased appropriately.