首页|期刊导航|中国标准化|公共经济学视角下医疗服务供给与医保付费精细化机制的规范化发展路径研究

公共经济学视角下医疗服务供给与医保付费精细化机制的规范化发展路径研究OACHSSCD

Research on the Standardized Development Path of the Refined Mechanism of Medical Service Supply and Medical Insurance Payment from the Perspective of Public Economics

中文摘要英文摘要

DIP付费模式是我国目前普遍采用的一种新付费模式,具有促进医保基金有效利用、卫生资源合理配置、控制医疗费用不合理增长的优势,但DIP付费模式与长期住院病例的支付准确性较低,达到高倍率病例标准人数有限,患者在医院间旅行现象突出,群众投诉较多;而医院方面面临的问题主要集中于DIP付费折算费用不足、医院绩效考核与疾病周转效率指标受限、转院与回归难等方面,造成了一定的医疗资源浪费.基于此,本研究以公共经济学为背景,探讨惠州市医疗服务供给与医保付费精细化发展现状,并基于配套政策以及供给服务内部精细化管理等方面提出规范化的发展对策,旨在提升医院运行效能,满足国民的健康需求.

The DIP payment model is a new payment model widely adopted in China at present.It has the advantages of promoting the effective utilization of medical insurance funds,the rational allocation of health resources,and controlling the unreasonable growth of medical expenses.However,the payment accuracy of the DIP payment model for long-term inpatient cases is relatively low,the number of people meeting the high-multiple case standard is limited,and the phenomenon of patients traveling between hospitals is prominent.There are many complaints from the public.The problems faced by hospitals mainly focus on insufficient DIP payment conversion fees,restricted indicators for hospital performance assessment and disease turnover efficiency,and difficulties in transferring and returning to other hospitals,which have led to a certain waste of medical resources.Based on this,this study takes public economics as the background to explore the current situation of the refined development of medical service supply and medical insurance payment in Huizhou City.It also proposes standardized development countermeasures based on supporting policies and the refined management within the supply of services,aiming to enhance the operational efficiency of hospitals and meet the health needs of the people.

金程;钟勇辉;李丹

惠州市中心人民医院惠州市中心人民医院惠州市中心人民医院

公共经济学医疗服务供给医保付费精细化机制规范化发展路径

public economicsmedical service supplymedical insurance paymentrefined mechanismstandardized development path

《中国标准化》 2026 (10)

267-270,4

10.3969/j.issn.1002-5944.2026.10.046

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