| 引用本文：林坤河, 上官业声, 饶娅琦, 彭静, 陈翼, 姚轶凡, 熊英贝, 项莉.DIP支付方式下医保供给侧政策协同对费用控制的影响研究[J].中国卫生政策研究,2024,17(5):17-24 |
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| DIP支付方式下医保供给侧政策协同对费用控制的影响研究 |
| 投稿时间：2024-03-16 修订日期：2024-05-07 PDF全文浏览 HTML全文浏览 |
| 林坤河1, 上官业声2, 饶娅琦2, 彭静3, 陈翼3, 姚轶凡1, 熊英贝1, 项莉1,4 |
1. 华中科技大学同济医学院医药卫生管理学院 湖北武汉 430030;
2. 宜昌市医疗保障局 湖北宜昌 420500;
3. 宜昌市医疗保障服务中心 湖北宜昌 420500;
4. 国家医疗保障研究院华科基地 湖北武汉 430030 |
| 摘要:目的：本研究旨在探索DIP支付方式与其他医保供给侧政策间的协同效果。方法：以全国DIP改革试点城市A市为处理组，未改革城市B市为对照组进行比较研究。收集2019—2022年共1 120个公立医疗机构样本，采用双重差分法对住院医疗总费用及部分费用结构进行分析。结果：A市DIP改革对医疗机构住院医疗总费用、住院检查化验总费用产生显著的抑制效应，对住院药品总费用和住院材料总费用未产生影响。结论：DIP支付方式发挥显著控费效果，住院医疗总费用得到有效控制；单纯采取调价政策与集采政策的控费效果尚有不足；DIP与其他供给侧政策协同，促进医疗费用结构更加合理。建议医保部门注重发挥供给侧政策协同作用，共同推动医保基金使用效率提升。 |
| 关键词:DIP支付方式 供给侧改革 医疗服务价格调整 药品/耗材集中采购 |
| 基金项目:国家自然科学基金项目(72174068)；中央高校基本科研业务费专项资金资助项目(YCJJ20242228) |
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| Research on the impact of supply side policy coordination of medical insurance on cost control under DIP payment method |
| LIN Kun-he1, SHANGGUAN Ye-sheng2, RAO Ya-qi2, PENG Jing3, CHEN Yi3, YAO Yi-fan1, XIONG Ying-bei1, XIANG Li1,4 |
1. School of Medicine Health Management of Tongji Medical College of Huazhong University of Science and Technology, Wuhan Hubei 430030, China;
2. Yichang Medical Security Bureau, Yichang Hubei 420500, China;
3. Yichang Medical Security Service Center, Yichang Hubei 420500, China;
4. HUST Base of National Institute of Healthcare Security, Wuhan Hubei 430030, China |
| Abstract:Objective: This study aims to explore the synergistic effects of DIP and other medical insurance supply-side policies. Method: City A that has piloted DIP reform was set as the treatment group, and City B without reform was set as the control group. A total of 1 120 public medical institution samples from 2019 to 2022 were collected. The total medical expenses during hospitalization and some structural expenses were analyzed using DID method. Result: DIP had a significant inhibitory effect on the medical expenses, and the expenses of checkups and examinations during hospitalization in city A, but had no impact on the drug and the material expenses during hospitalization. Conclusion: DIP played a significant cost control role and effectively controlled the total medical expenses during hospitalization. The synergistic effects of price adjustment of medical services policy and national centralized drug/material procurement policy on cost control were insufficient. DIP synergized with other supply-side policies to promote rational medical cost structure. It is suggested that medical insurance departments should focus on the synergistic effects of medical insurance supply-side policies to jointly improve the efficiency of medical insurance fund utilization. |
| Key words:DIP payment method Supply side reform Price adjustment of medical services policy National centralized drug/material procurement policy |
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