[1]李春漾冯海欢辜永红孙麟李家喻田雯虹邱烱.医疗保险基金支付方式改革对医疗质量的影响分析[J].中国卫生质量管理,2017,24(03):31-34.[doi:10.13912/j.cnki.chqm.2017.24.3.11]

点击复制

医疗保险基金支付方式改革对医疗质量的影响分析

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 第24卷期数: 2017年03期页码: 31-34 栏目: 医疗质量出版日期: 2017-05-28

作者:: 李春漾冯海欢辜永红孙麟李家喻田雯虹邱烱; 四川大学华西医院

关键词:: 血液透析; 支付方式改革; 按医疗质量付费; 控制费用增长; 提高医疗质量

Keywords:: Hemodialysis; Medical Insurance Payment Reform; Fee for Medical Quality; Cost Control; Medical Quality Enhancement

DOI:: 10.13912/j.cnki.chqm.2017.24.3.11

摘要:: 探讨支付方式改革在医疗质量提升及医疗费用控制中的作用，以成都市门诊特殊疾病血液透析（门特血透）为例，分析了支付方式改革的必要性。目前，门特血透支付方式已从传统按项目付费过渡到按病种定额付费，以2014年成都市内两家收治患者情况类似的三级医院为例，模拟门特血透支付方式改革后的医院运行情况。探讨支付方式的改革可以间接督促医院医疗质量的提升和服务效率的提高。应在广泛准确收集数据的基础上，根据门特血透质效评价结果对医疗机构实行按医疗质量付费。

Abstract:: To explore the influence of medical insurance payment reform on medical quality enhancement and medical cost control, this study analyzed the significance of medical insurance payment reform on hemodialysis among outpatients with specific disease in Chengdu. At present, the payment of hemodialysis for outpatient specific diseases has been changed from Fee for Service (FFS) into Fee for Diseases Related Groups. Taking two hospitals with similar diseases of patients as example, the results in these two hospitals after medical insurance payment reform in 2014 were simulated. Medical insurance payment reform could indirectly supervise medical quality and enhance service efficiency. In the future, based on widely data collection, medical insurance payment could be changed into Fee for Medical Quality according to the cost-effectiveness analysis results.

参考文献/References:

［1］中华人民共和国国家统计局. 中国统计年鉴［Z］.中国统计, 2015.

相似文献/References:

[1]李春漾冯海欢孙麟.胆囊炎疾病诊断相关分组与细分组研究初探[J].中国卫生质量管理,2018,25(02):9.[doi:10.13912/j.cnki.chqm.2018.25.2.03]
[2]高菊林辛霞车文芳梁珊珊刘小敏.应用护理敏感质量指标提升血液透析质量[J].中国卫生质量管理,2018,25(05):67.[doi:10.13912/j.cnki.chqm.2018.25.5.21]
[3]李墨奇王代红何文昌伍薇王沂芹宋彩萍王亚玲高家蓉陈锦.降低血液透析患者体外循环凝血发生率[J].中国卫生质量管理,2019,26(01):91.[doi:10.13912/j.cnki.chqm.2019.26.1.27]
[4]赵晓娟谢宇李永斌郑见立向国春汪才靖.医保新政的政策逻辑及对民营医院的影响分析[J].中国卫生质量管理,2020,27(02):119.[doi:10.13912/j.cnki.chqm.2020.27.2.36]
[5]李亚萍党双锁.一起丙型肝炎感染事件引发的思考[J].中国卫生质量管理,2020,27(03):76.
　LI Yaping,DANG Shuangsuo.Reflection on An Incident of Hepatitis C Infection[J].Chinese Health Quality Management,2020,27(03):76.
[6]明敏馨王楠孙辉.社会办独立血液透析中心和医院血液透析中心的对比分析[J].中国卫生质量管理,2021,28(07):40.[doi:10.13912/j.cnki.chqm.2021.28.7.11 ]
　MING Minxin,WANG Nan,SUN Hui.Comparative Analysis of Patients in Independent Hemodialysis Center Run by Society and Hospital Hemodialysis Center[J].Chinese Health Quality Management,2021,28(03):40.[doi:10.13912/j.cnki.chqm.2021.28.7.11 ]
[7]刘小敏高菊林李晨陆李珊珊么莉尚文涵向晶徐建鸣辛霞.血液透析护理质量控制指标构建与应用[J].中国卫生质量管理,2022,29(10):23.[doi:10.13912/j.cnki.chqm.2022.29.10.06 ]
　LIU Xiaomin,GAO Julin,LI Chenlu.Construction and Application of Hemodialysis Nursing Quality Control Index[J].Chinese Health Quality Management,2022,29(03):23.[doi:10.13912/j.cnki.chqm.2022.29.10.06 ]
[8]范晓琪宋多王智帆管宏才李乔晟简伟研王岩.DRG付费对医生行为和医疗质量的影响研究：以踝关节和脊柱融合术为例[J].中国卫生质量管理,2022,29(08):46.[doi:10.13912/j.cnki.chqm.2022.29.8.11 ]
　FAN Xiaoqi,SONG Duo,WANG Zhifan.Impact of DRG Reform on Doctors' Behaviors and Medical Quality: Taking Ankle and Spinal Arthrodesis as Examples[J].Chinese Health Quality Management,2022,29(03):46.[doi:10.13912/j.cnki.chqm.2022.29.8.11 ]
[9]李芳夏莎杜丽娜杨锦涛卫攀王思佳王培冯晶.提高血液透析监测有效率[J].中国卫生质量管理,2024,31(11):74.[doi:10.13912/j.cnki.chqm.2024.31.11.17]
　LI Fang,XIA Sha,DU Lina.Improve the Efficiency of Hemodialysis Monitoring[J].Chinese Health Quality Management,2024,31(03):74.[doi:10.13912/j.cnki.chqm.2024.31.11.17]
[10]化得良李祉睿宋金霞栗梦婷魏莉莉张曦皞张维.我国DRG支付方式改革对医疗机构服务效率影响的系统评价[J].中国卫生质量管理,2025,32(08):38.[doi:10.13912/j.cnki.chqm.2025.32.8.09]
　HUA Deliang,LI Zhirui,SONG Jinxia.Systematic Review of the Impact of China’s Diagnosis Related Groups Payment Method Reform on the Service Efficiency of Medical Institutions[J].Chinese Health Quality Management,2025,32(03):38.[doi:10.13912/j.cnki.chqm.2025.32.8.09]

更新日期/Last Update: 2017-05-28