| 摘要: |
| 文章分析了现行价格项目规范面临的主要问题：价格项目拆分过细、区域间差异大，影响计价，与患者的感受脱节；未厘清技术规范、新增价格项目和价格项目规范的关系，影响临床改良创新；将耗材、试剂打包在项目内收费，不适应物耗与医疗服务成本价格变化规律；各省份价格项目目录除外内容不统一，与耗材注册、医保支付之间缺乏衔接。完善医疗服务价格项目规范的政策建议包括：整合各地现行医疗服务价格项目目录，统一更新《全国医疗服务价格项目规范》；医疗服务项目技术规范和价格项目规范相衔接，促进创新医疗技术临床应用；依托全国统一的新增、修订医疗服务价格信息平台，共享联动价格项目要素；立项体现技耗分离，兼顾技术创新与价格规律，让医院靠技术价值获得回报；编制可单独收费一次性耗材目录，与耗材注册、医保支付政策之间保持衔接；医保基金监管与医院申报新增、修订价格项目协同，让临床更好计价、执行。 |
| 关键词: 医疗服务价格项目规范 项目内涵 计价说明 技耗分离 成本测算 |
| DOI： |
| 投稿时间：2023-04-21 |
| 基金项目: |
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| Implementation, Facing Problems and Improvement of Current Medical Service Price Items Standard |
| Zheng Da-xi |
| (Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 ,China) |
| Abstract: |
| It analyzes the main problems faced by the current price item specification: the overly detailed price items, the large re- gional differences, the pricing impact, and the disconnected patients’ feeling; the relationship between technical norms, new price items and price item norms is not clarified, affecting clinical improvement and innovation; consumables and reagents are packaged and charged within the items, not adapting to the law of price changes in material consumption and medical service costs; the content of the price item catalogue exclusions is not uniform across provinces, and there is a lack of articulation between registration of consum- ables and medical insurance payments. The policy recommendations for improving the price specifications for medical services include: integrating the existing price catalogues of medical services in different regions and unifying and updating the national price specifica- tions for medical services; linking the technical specifications for medical services with the price specifications to promote the clinical application of innovative medical technologies; relying on a unified national information platform for new and revised medical services prices to share the elements of linked price items; reflecting the separation of technology and consumption in the establishment of projects reflects the separation of technology and consumption, taking into account technological innovation and price laws, allowing hospitals to obtain returns on the value of technology; compiling a catalogue of disposable consumables that can be charged separately, maintaining a linkage with the registration of consumables and the policy of payment by medical insurance; the supervision of medical insurance funds and the declaration of new and revised price items by hospitals in synergy, allowing better clinical pricing and implemen- tation. |
| Key words: medical service price items standard item connotation pricing instruction separation of technology and consumption cost measurement output orientation |
