| 引用本文：冯逸佳, 张璐莹, 李骄阳, 齐怡嘉, 陈文.我国DRG/DIP付费下创新医疗技术支付机制政策分析[J].中国卫生政策研究,2024,17(9):1-5 |
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| 我国DRG/DIP付费下创新医疗技术支付机制政策分析 |
| 投稿时间：2024-05-24 修订日期：2024-08-02 PDF全文浏览 HTML全文浏览 |
| 冯逸佳1,2, 张璐莹1,2, 李骄阳1,2, 齐怡嘉1,2, 陈文1,2 |
1. 复旦大学公共卫生学院 上海 200032;
2. 复旦大学长三角医疗保障研究中心 上海 200032 |
| 摘要:目的： 梳理我国DRG/DIP付费下创新医疗技术支付机制实践进展，并提出政策建议。方法： 收集2024年4月前各省市DRG/DIP付费改革政策文件做内容分析，并对部分城市医疗保障部门负责人展开访谈。结果： 45个国家试点和19个省级扩面城市的文件中包含创新医疗技术支付机制。DRG付费城市划分为调整分组权重/机构系数、单独支付等8类做法，DIP付费城市划分为专家评议确定加成分值、采用不同计算规则确定分值等6类做法。上海、杭州、南京较有特色，分别为支持产业发展向新技术倾斜、设置退坡激励和多维调节机制下精准补偿。结论： 需要在国家或省级层面统一界定新技术的范围，完善准入和退出机制；利用退坡激励促进短期支付向长期支付过渡；坚持总额控制，强化对新技术的监管。 |
| 关键词:DRG/DIP付费 创新医疗技术 支付机制 政策分析 |
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| Policy analysis on innovative medical technologies payment mechanism under DRG/DIP payment in China |
| FENG Yi-jia1,2, ZHANG Lu-ying1,2, LI Jiao-yang1,2, QI Yi-jia1,2, CHEN Wen1,2 |
1. School of Public Health, Fudan University, Shanghai 200032, China;
2. Yangtze Delta Institute of Health Insurance Research, Fudan University, Shanghai 200032, China |
| Abstract:Objective: To collate the progress of innovative medical technology payment mechanism under DRG/DIP payment in China, and raise suggestions for policy improvement. Methods: The study analysed policy documents on DRG/DIP payment reform in provinces and municipalities up to April 2024 and conducted in-depth interviews with relevant heads of healthcare security departments in some pilot cities. Results: A total of 45 national reform pilot cities and 19 provincial expansion cities included innovative technology payment mechanisms in the reform documents. The innovative technology payment mechanism for DRG-paying cities includes eight types of practices such as adjusting subgroup weights/institutional coefficients, separate payment, etc. The DIP-paying cities are classified into six types of practices such as determining the additive scores after expert deliberation, and determining the scores by adopting different computation rules. The practices of Shanghai, Hangzhou and Nanjing are more typical, namely tilting towards new technologies in supporting industrial development, setting up regressive incentives and precise compensation under a multi-dimensional adjustment mechanism. Conclusion: It is necessary to give a harmonised definition of innovative technologies at the national or provincial level and to complete its access and exit mechanism; using the rebate incentive mechanism helps promote the transition from short-term to long-term payments; adherence to the total amount of control payment and improvement of the regulation are important. |
| Key words:DRG/DIP payment Innovative medical technologies Payment mechanism Policy analysis |
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