| 引用本文：谭贵泓, 任晓晖, 刘志军, 李宁秀, 王婧.医疗服务提供方对按病种定额付费政策的认知现状——以四川省成都市为例[J].中国卫生政策研究,2014,7(4):38-43 |
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| 医疗服务提供方对按病种定额付费政策的认知现状——以四川省成都市为例 |
| 投稿时间：2013-05-27 修订日期：2014-01-08 PDF全文浏览 HTML全文浏览 |
| 谭贵泓, 任晓晖, 刘志军, 李宁秀, 王婧 |
| 四川大学华西公共卫生学院 四川成都 610041 |
| 摘要:目的：了解医疗服务提供方对按病种定额付费政策的认知现状，为进一步完善相关政策提供依据。方法：采用半结构式访谈方法，对9家医院38名工作人员和患者进行深入访谈。结果：各级医院积极执行按病种定额付费政策，并制定了相应的费用控制和管理措施，但各医院按病种定额结算的病例比例较低，在执行过程中存在着对病例纳入依据认识不一致、医疗服务提供方认为费用标准制定较为笼统等问题。结论：成都市按病种定额付费取得了一定成效，但也存在一些问题，需根据病种费用信息测算标准费用，完善按病种定额付费结算方式；进一步明确按病种定额付费病例的纳入依据和原则；逐步增加按病种定额付费疾病的种类；加强对医疗服务提供方的监管力度；引导医疗服务提供方建立有效的激励机制。 |
| 关键词:按病种定额付费 效果 评估 深入访谈 |
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| Study on the cognition status of implementing case-based payment policy among healthcare providers：A case in Chengdu, Sichuan Province |
| TAN Gui-hong, REN Xiao-hui, LIU Zhi-jun, LI Ning-xiu, WANG Jing |
| West China School of Public Health, Sichuan University, Sichuan Chengdu 610041, China |
| Abstract:Objective: To understand the implementation status of case-based payment among healthcare providers and their cognition on the matter. Methods: Semi-structured interview was conducted on 30 purposely selected staff from 9 hospitals in Chengdu. Results: After one-year implementation of case-based payment, hospitals at different level carried out the policy vigorously: executed corresponding expense control measures and management. Nevertheless, the proportion of cases that were paid with case-based payment was low, moreover the inclusion criteria for case was of disunity and the formulation of the expense standard was ambiguous to some extent. Conclusion: Certain achievements were accompanied with problems, so it is essential to refine reimbursement standards, improve case-based payment, make clear the inclusion criteria for case and extend the covering range of case-based payment in Chengdu. In addition, the medical insurance agency should strengthen the supervision of healthcare providers,and guide them to set up effective incentive mechanism. |
| Key words:Case-based payment Effect Evaluation In-depth interview |
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