摘要
2022版国家医保药品目录部分限定支付范围表述不够清晰,临床准确执行存在困难。本文从肾脏病方向梳理相关医保药品限定支付范围疑义条目,经30位专家三轮次德尔菲法、16名专家共识会议法投票表决后提出7条细则与4条修订建议,为医保药品限定支付范围细则研究提供参考,为医保部门精细化管理、临床精准化执行提供依据。
The limited payment scope of some medical insurance drug catalogs is not clearly stated,and there are difficulties in accurate clinical implementation.From the perspective of kidney disease,this paper combs the doubtful items of the limited payment scope of related medical insurance drugs.After three rounds of Delphi method method voting by 30 experts and consensus meeting method voting by 16 experts,seven detailed rules and four revision suggestions are proposed,providing reference for the study of the detailed rules of the limited payment scope of medical insurance drugs,and providing basis for the refined management and clinical precision implementation of the medical insurance department.
出处
《中国医疗保险》
2023年第8期122-126,共5页
China Health Insurance
基金
福建省医疗保障研究院2023年调研项目“医保药品限定支付政策专家共识调研”(2023D01)
福建省卫生健康委员会2022年省卫生健康软科学研究课题“医保限定支付药品合规使用情况研究”(2022RKB009)。
关键词
医保药品
限定支付
肾脏病
德尔菲法
共识会议法
medical insurance drugs
restricted payment
kidney disease
Delphi method
consensus meeting method
