| 引用本文: |
曹晓琳,张小娟,聂子潞,等.传统DIP向总额控制下的DIP转型分析*[J].中国卫生经济,2023,42(1):33-36.[点击复制] |
CAO Xiao-lin,ZHANG Xiao-juan,NIE Zi-lu,et al.Analysis on the Practice of Traditional Diagnosis-Intervention Packet(DIP) and the Transformation Mode to National DIP[J].CHINESE HEALTH ECONOMICS,2023,42(1):33-36.[点击复制] |
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| 传统DIP向总额控制下的DIP转型分析* |
| 曹晓琳,张小娟,聂子潞,刘阳,彭博,叶媛,蒋瑶,郭文丽,李亚子 |
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| (中国医学科学院医学信息研究所 北京 100020;贵州省医保基金运行服务中心 贵阳 550002;北京邮电大学图书馆 北京 100876) |
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| 摘要: |
| 芜湖市作为国内较早一批探索按病种分值付费的城市之一，通过多年实践探索出了病种标准、医院系数、特例单议、个人负担控制比例、费用结算、医院互查及沟通协商等一套传统的按病种分值付费体系。为顺应国家医保支付方式改革趋势，文章依据芜湖市经验就如何实现传统按病种分值付费向总额控制下基于大数据的按病种分值付费模式的转变，如何实现“同病同城同保障”，为按病种分值付费与特殊医疗需求的矛盾等问题提出建议。 |
| 关键词: 医保支付方式 按病种分值付费 总额控制 实践经验 |
| DOI： |
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| 基金项目:中国医学科学院医学信息研究所/图书馆2019年度重点科研专项 (2019ZD003)；北京市社会科学基金项目(19XCB004) |
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| Analysis on the Practice of Traditional Diagnosis-Intervention Packet(DIP) and the Transformation Mode to National DIP |
| CAO Xiao-lin,ZHANG Xiao-juan,NIE Zi-lu,LIU Yang,PENG Bo,YE Yuan,JIANG Yao,GUO Wen-li,LI Ya-zi |
| () |
| Abstract: |
| As one of the first cities in China to explore Diagnosis-Intervention Packet (DIP)，Wuhu has explored a complete set of payment system through many years of practice，such as disease type standard，hospital coefficient，special case single negotiation，personal burden control proportion，cost settlement，hospital mutual inspection，communication and negotiation. In order to conform to the reform trend of the national medical insurance payment method，suggestions are made on how to realize the transformation from the traditional DIP to the based on big data under the total control，how to realize the same disease，the same city and the same security，and how to deal with the contradiction between the DIP and special medical needs. |
| Key words: mcdical insurance payment mcthod Diagnosis-Intervention Packct total amount conrtol practical cxpcricnec |