引用本文:卢建龙,祁方家,应晓华.社会历史背景视角下的支付方式改革——以德国、英国和台湾地区为例[J].中国卫生政策研究,2013,6(9):18-23 |
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社会历史背景视角下的支付方式改革——以德国、英国和台湾地区为例 |
投稿时间:2013-03-26 修订日期:2013-06-26 PDF全文浏览 HTML全文浏览 |
卢建龙, 祁方家, 应晓华 |
复旦大学公共卫生学院 上海 200032 |
摘要:通过文献查阅及专家访谈,收集德国按疾病诊断分组、英国按人头付费以及台湾地区总额预付制三种支付制度建立的社会历史背景资料,发现影响德国DRGs实施的主要社会历史背景是政党的更迭和医院管理的不透明;英国按人头付费的主要影响因素是对支付制度历史习惯的延续;台湾总额预付制是为了在不改变传统按服务项目付费的基础上而采取的控费方式。通过上述影响因素推演我国的支付方式改革可能需要经过总额预付制的过渡过程,并通过完善信息支撑,最终会走向DRGs方式。 |
关键词:医疗保险 支付方式 背景 |
基金项目:国家社会科学基金重大项目(11&ZD176) |
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Payment system reform from the perspective of social and historical background A case study of Germany, England and Taiwan |
LU Jian-long, QI Fang-jia, YING Xiao-hua |
School of Public Health, Fudan University, Shanghai 200032, China |
Abstract:To find out the influencing factors on implementation of DRGs in Germany, capitation in UK, and global budget in Taiwan, this paper collects the social and historical background information through a literature review and expert interviews. The conclusion is that the change of political party and opaque hospital management affects the implementation of DRGs in Germany. In England, capitation is an historical habit. However, the global budget in Taiwan has been applied to control health expenditure while keeping the fee-for-service system. We conclude that the payment system in China will transit from prepayment to DRGs supported by information system. |
Key words:Health insurance Payment system Background |
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