DRG亏损病组的精细化管理研究

Research on the Refined Management of Hospital Deficit Groups Under DRG Payment Method

DRG基于“结余留用、合理超支分担”的激励和风险分担机制,促使医疗机构形成控制费用的内在动力。在此背景下,长期连续亏损病组会阻碍医疗机构发展积极性,影响患者医疗服务可及性。本文从DRG分组原理出发,对国内外医疗机构普遍亏损病组进行归纳总结与亏损成因分析,以期在DRG付费改革持续推进的同时,为医保精细化管理与医院高质量发展提供参考。

Based on the incentive and risk-sharing mechanism of surplus retention and reasonable overspending sharing,DRG is promoting the internal motivation of medical institutions to control costs.In this context,long-term continuous deficit groups will hinder the initiative of medical institutions and affect the accessibility of patients’medical services.This paper starts from the principle of DRG grouping,summarizes and analyzes the common deficit groups of domestic and foreign medical institutions,by which providing reference for medical insurance refined management and hospitals high-quality development when DRG payment reform is extensively promoted.