| 引用本文：吴建,周学山,谢双保,等.河南省开展医疗服务综合支付改革的实践与思考[J].中国卫生政策研究,2012,5(7):39-44 |
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| 河南省开展医疗服务综合支付改革的实践与思考 |
| 投稿时间：2012-03-11 修订日期：2012-06-08 PDF全文浏览 HTML全文浏览 |
| 吴建1, 周学山2, 谢双保2, 张敏2, 赵要军3 |
| 1.郑州大学公共卫生学院;2.河南省卫生厅;3.赵要军 |
| 摘要:河南省在世行贷款/英国赠款中国农村卫生发展项目（卫Ⅺ项目）支持下，指导项目县开展以单病种付费为基础的综合支付改革活动。改革的核心思路是通过理顺医疗服务各方主体之间的职责关系，逐步推动经办机构成为战略服务购买者，并在医疗质量管理、服务监管、价格谈判、支付等方面开展了制度设计。其中，基于大数法则原理的分组分类支付技术是一种新型单病种付费模式，能够有效克服以往按病种付费改革中普遍存在的变异率高、纳入率低、覆盖率低等问题。文章还分析了项目县开展的综合支付改革对当前国家推进县级医院综合改革的借鉴意义。 |
| 关键词:医疗服务 综合支付 实践 |
| 基金项目:河南省世行贷款和英国赠款中国农村卫生发展项目咨询课题（HN ZX 2009 5A 4） |
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| The strategy and practice of comprehensive payment reform for medical service in Henan province |
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| Abstract:This article is mainly focused on the comprehensive single disease based payment reform in Henan Province, supporting by World Bank Loan /British grants Chinese Rural Health Development Project (Health Ⅺ project). It introduces the innovative activities implemented in the project counties such as medical quality management, service regulation, price negotiation, payment etc. The guiding ideology of the reform is to gradually promote health insurance agencies as strategic health services buyers through rationalization of duties and relationship between main parties in medical services. The key innovative technology called “Packet classification payment” is based on the principle of “law of large numbers” which can effectively overcome the common phenomenon as high variation rate, low into rate and low coverage rate happened in the disease based payment reform in past. It is a new model which is not instead of the previous single disease based payment reform. The author also analyzes the reference and meaning of the reform for promoting the comprehensive reform at county hospitals which is vigorously advocated by the government currently. |
| Key words:Medical Services Comprehensive Payment Practices |
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