美国基于价值购买支付改革试点经验及其启示

The pilot experience and enlightenment of value-based purchasing payment reform in the United States

美国是价值医疗支付改革试点实践最多的国家,基于价值购买(VBP)是其试点项目之一。作者从医院层次和医生层次分别介绍了美国VBP支付改革试点项目的基本情况和实施效果,并分析了其实施效果不理想的原因,并从价值医疗支付指标体系建设、价值医疗支付改革实施及管理成本方面提出了对我国的启示,以期为我国基于价值的优质医疗服务体系建设提供借鉴。

The United States is the country with the most pilot practices in value-based healthcare payment reform,and value-based purchasing(VBP)is one of its pilot projects.The authors introduced the basic situation and implementation effects of the pilot projects of VBP payment reform in the United States from the hospital and physician levels respectively,and analyzed the causes for their unsatisfactory implementation effects.Then,the authors proposed its enlightenments for China from such aspects as the construction of value-based medical payment index system,implementation of value-based medical payment reform,and management costs,to provide reference for the construction of high-quality value-based medical service system in China.