医保按病种分值付费在医院运营管理中的应用

Application of Medical Insurance Paying According to the Value of Disease in Hospital Operation and Management

随着科技的发展和社会的进步,医院加强医疗成本的管控,减少医保支出,降低医保支付比例,对促进国民医疗的良性运行有重要意义。医保按病种分值付费(DIP)倒逼了医院实施医疗管理的升级与资源的优化,以绩效改革杠杆调动医务人员工作积极性,更好地融入绩效考核,强化医疗质量与医疗费用管理,促使临床科室更为重视医疗质量与医疗水平,控制医疗费用与成本,确保医院的公益性,实现医院的运营效率平衡。该文主要针对DIP医保付费在医院运营中的应用情况进行综述。

With the development of science and technology and the progress of society,hospitals should strengthen the control of medical costs,reduce medical insurance expenditure and reduce the proportion of medical insurance payment,which is of great significance to promote the benign operation of national medical care.Medical insurance pays by disease(DIP)has forced hospi⁃tals to upgrade medical management and optimize resources,leveraging performance reform to motivate medical staff and better in⁃tegrate them into performance evaluations.It can strengthen medical quality and medical cost management,promote clinical de⁃partments to pay more attention to medical quality and medical level,control medical expenses and costs,ensure the public wel⁃fare of the hospital,and achieve the balance of hospital operation efficiency.This paper mainly reviewed the application of DIP medical insurance payment in hospital operation.