中医医院开展DRG支付方式改革现状与思考

Current status and considerations of DRG payment reform in Traditional Chinese Medicine hospitals

DRG支付方式改革是深化医药卫生体制改革的全新举措,也是中医药事业和中医医院高质量发展的重要手段。中医特色诊疗服务体系具有独特性,中医医院开展DRG支付方式改革面临诸多挑战。通过对中医医院DRG支付方式改革实施过程进行分析,发现中医医院仍面临DRG支付方式与中医辨证论治难契合、中医诊疗供给能力和应用范围有限、面临财务风险压力、中医特色诊疗难以发挥及信息化建设滞后等问题。中医医院需要从政策和医院管理两方面着手,结合中医优势病种,修改完善DRG支付方案,发挥中医特色诊疗优势,加快中医医院医保支付方式改革步伐,推动中医医院和中医药事业持续高质量发展。

DRG payment reform is a new measure to deepen the reform of the medical and health system,and it is also an important means for the high-quality development of Traditional Chinese Medicine(TCM)affairs and hospitals.The TCM characteristic diagnosis and treatment service system has its uniqueness,and TCM hospitals face many challenges in implementing DRG payment reform.Through the analysis of the DRG payment reform process in TCM hospitals,it is found that TCM hospitals still face challenges such as the difficulty of integrating DRG payment methods with TCM syndrome differentiation and treatment,limited TCM diagnosis and treatment supply capacity and application scope,financial risk pressures,difficulties in leveraging TCM characteristic diagnosis and treatment,and lagging information technology construction.TCM hospitals need to start from both policy and hospital management aspects,combine TCM advantage diseases,modify and improve the DRG payment scheme,leverage the advantages of TCM characteristic diagnosis and treatment,accelerate the pace of medical insurance payment reform in TCM hospitals,and promote the sustained high-quality development of TCM hospitals and TCM affairs.