| 引用本文：谭清立, 刘思妍, 柳丹玲, 刘欣悦, 廖雨晴.按病种分值付费对医生行为的影响——基于实验经济学[J].中国卫生政策研究,2021,14(9):14-19 |
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| 按病种分值付费对医生行为的影响——基于实验经济学 |
| 投稿时间：2021-09-06 修订日期：2021-09-15 PDF全文浏览 HTML全文浏览 |
| 谭清立1,2, 刘思妍1, 柳丹玲1, 刘欣悦1, 廖雨晴1 |
1. 广东药科大学医药商学院 广东中山 528453;
2. 广东省药品监管科学研究基地 广东广州 510008 |
| 摘要:本文通过收集临床医学及其他相关医学专业学生的调查问卷，从总体水平、3种健康类型、15种患者类型以及最优服务量决策4个方面，以医学生在不同医保支付方式下的医疗卫生服务提供量的决策模拟分析按病种分值付费对医生行为的影响。结果显示，两种支付方式下医生的医疗卫生服务提供量具有显著差异，按项目付费使得医生提供过多的医疗服务数量，而按病种分值付费能够有效规范医生医疗服务提供行为，做出更多适合病人的最优决策。建议继续完善按病种分值付费，支付方式应更具灵活性；医生薪酬标准多元化，健全医生激励补偿机制；建立健全医疗服务监测评估机制。 |
| 关键词:按病种分值付费 按项目付费 医保支付方式 医生行为 |
| 基金项目:广东省医学科学研究基金（B2019233）；大学生创新创业训练计划项目（S20190573049） |
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| A study on the impacts of Diagnosis-Intervention Packet on physicians' behaviors: Based on experimental economics |
| TAN Qing-li1,2, LIU Si-yan1, LIU Dan-ling1, LIU Xin-yue1, LIAO Yu-qing1 |
1. School of Medical Business, Guangdong Pharmaceutical University, Zhongshan Guangdong 528453, China;
2. Guangdong Research Base for Drug Regulatory Science, Ghuangzhou Guangdong 510008, China |
| Abstract:By collecting the questionnaires from students majoring in clinical medicine and other related medical majors, the authors of this paper analyzed the medical students' decisions on the quantity of medical and health services (MHS) provided under different medical insurance payment modes from four aspects, i.e. overall level, 3 types of health, 15 types of patients and optimal service quantity. The analysis results show that:there is a significant difference in the quantity of MHS provided by physicians under two different payment modes:FFS and DIP. Fee-for-Service (FFS) makes a physician to provide too much medical services, while Diagnosis-Intervention Packet (DIP) can effectively regulate physicians' behaviors of providing medical services and drive physicians to make more optimal decisions suitable for patients. Finally, three suggestions are put forward as follows:1. Efforts should be made to continue to improve the DIP payment mode, and the payment method should be more flexible; 2. Work should be done to diversify the salary standard for physicians and further improve the incentive compensation mechanism for physicians; 3. It is suggested to establish a sound mechanism for testing and evaluation of medical services. |
| Key words:Diagnosis-Intervention Packet (DIP) Fee-for-Service (FFS) Medical insurance payment modes Physicians' Behaviors |
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