Objective To implement the national diagnosis related group(DRG)policy smoothly,and gradually move towards value medicine and fine management,some suggestions are put forward for improving medical service efficiency,s...Objective To implement the national diagnosis related group(DRG)policy smoothly,and gradually move towards value medicine and fine management,some suggestions are put forward for improving medical service efficiency,saving medical insurance fund,and reducing the burden of patients,so as to realize the win-win situation of medical insurance and patients.Methods Based on the experience of the United States,Australia,and Germany,the policy implementation background and development process in China were summarized.The advantages and disadvantages of single disease payment method,disease score payment method,and diagnosis related groups-prospective payment system(DRG-PPS)method were compared,and then the problems were found out.Results and Conclusion In view of the imperfect information system,lack of professional talents,and uneven progress of each pilot,it is proposed that relevant departments should pay more attention to the construction and improvement of coding and other information systems,cultivate professional talents,promote the reform of DRG payment technology specification and grouping technology combined with national pilot project,thus enhancing the application and in-depth development of DRG policy in China.展开更多
基金General Projects of Social Science Planning Fund of Liaoning Province(L19BGL034)Shenyang Philosophy and Social Science Planning Fund Project(SZ202001L)Key Projects of Shenyang Social Science Fund(SYSK2020-04-01).
文摘Objective To implement the national diagnosis related group(DRG)policy smoothly,and gradually move towards value medicine and fine management,some suggestions are put forward for improving medical service efficiency,saving medical insurance fund,and reducing the burden of patients,so as to realize the win-win situation of medical insurance and patients.Methods Based on the experience of the United States,Australia,and Germany,the policy implementation background and development process in China were summarized.The advantages and disadvantages of single disease payment method,disease score payment method,and diagnosis related groups-prospective payment system(DRG-PPS)method were compared,and then the problems were found out.Results and Conclusion In view of the imperfect information system,lack of professional talents,and uneven progress of each pilot,it is proposed that relevant departments should pay more attention to the construction and improvement of coding and other information systems,cultivate professional talents,promote the reform of DRG payment technology specification and grouping technology combined with national pilot project,thus enhancing the application and in-depth development of DRG policy in China.
