DRG下医方编码行为背后的认知思维与逻辑动因

Cognition and Motivation Logic behind the Coding of Medical Institutions under DRG

按疾病诊断相关分组(DRG)支付方式对抑制医疗费用的不合理增长、提高医疗服务质量和效率发挥了重要作用。保证诊断编码的准确性是实施DRG支付方式的首要前提。基于行为经济学理论下的透镜模型、双系统理论、前景理论,分析DRG下医方编码行为背后的认知思维与逻辑动因并提出对应的建议,为提高DRG编码准确性、推进DRG支付方式改革提供一个新的理论视角。

The DRG payment has a significant impact on controlling the escalation of medical expenses and enhancing the quality and efficiency of healthcare.Ensuring the accuracy of diagnostic coding is the fundamental requirement for the DRG payment to be enforced.Based on the lens model,dual-system theory and prospect theory of behavioral economics,the cognition and motivation logic behind the coding of medical institutions under DRG are analyzed.It puts forward the corresponding suggestions,so as to provide a new theoretical perspective for improving the accuracy of DRG coding and advancing the implementation of the DRG payment reform.