[1]方金鸣陶红兵.基于博弈理论的DRG支付对三级医院疾病诊治难度的影响分析[J].中国卫生质量管理,2023,30(07):024-29.[doi:10.13912/j.cnki.chqm.2023.30.7.06 ]
　FANG Jinming,TAO Hongbing.Influence of DRG Payment on the Difficulty of Diagnosis and Treatment of Diseases in Tertiary Hospitals Based on Game Theory[J].Chinese Health Quality Management,2023,30(07):024-29.[doi:10.13912/j.cnki.chqm.2023.30.7.06 ]
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基于博弈理论的DRG支付对三级医院疾病诊治难度的影响分析
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第30卷
期数:
2023年07期
页码:
024-29
栏目:
医疗质量
出版日期:
2023-07-15

文章信息/Info

Title:
Influence of DRG Payment on the Difficulty of Diagnosis and Treatment of Diseases in Tertiary Hospitals Based on Game Theory
作者:
方金鸣陶红兵
武汉市第四医院
Author(s):
FANG Jinming; TAO Hongbing
Fourth Hospital of Wuhan
关键词:
博弈理论; DRG; 三级医院; 疾病诊治难度; 病例组合指数
Keywords:
Game Theory;  DRG; Tertiary Hospital;  Difficulty in Diagnosis and Treatment of Diseases;  Case Mix Index
分类号:
R197.323
DOI:
10.13912/j.cnki.chqm.2023.30.7.06
文献标志码:
A
摘要:
目的分析疾病诊断相关分组（DRG）支付对三级医院疾病诊治难度的影响,探索医疗质量管理的最优策略。方法构建并求解三级医院在按项目付费下和DRG支付下疾病诊治难度的博弈模型，得到均衡解，并通过实证数据验证博弈结果。结果在按项目付费下，三级医院会将疾病诊治难度维持在一定水平。DRG支付可以促进三级医院提升疾病诊治难度，降低医疗资源消耗，提升诊治效率。结论按项目付费已不能适用于现代医保基金的管理要求，三级医院在按DRG支付后会逐渐提升疾病诊治难度，但需要辩证看待医疗资源消耗问题。
Abstract:
ObjectiveTo analyze the influence of DRG payment on the difficulty of disease diagnosis and treatment in tertiary hospitals and explore the optimal strategy of medical quality management.MethodsGame model for the difficulty of disease diagnosis and treatment in tertiary hospitals under fee-for-service payment and DRG payment was constructed and solved, and the equilibrium solution was obtained. The game results were verified by empirical data.ResultsUnder the fee-for-service payment, tertiary hospitals will maintain the difficulty of disease diagnosis and treatment at a certain level. DRG payment can promote tertiary hospitals to improve the difficulty of disease diagnosis and treatment, reduce the consumption of medical resources and improve the efficiency of diagnosis and treatment.Conclusion The fee-for-service payment can no longer be applied to the modern management of medical insurance, and the difficulty of disease diagnosis and treatment will gradually increase after the DRG payment in tertiary hospitals, but the consumption of medical resources needs to be treated dialectically.

参考文献/References:

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更新日期/Last Update: 2023-07-15