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我国医疗服务收付费方式改革进入DRG时代

2017-09-22 07:38:07   中国经济网

“DRG本身是一个工具,好比一个杠杆,而支付和收费是一个支点,这个杠杆利用这个支点撬动下,带来的是医院内部运行机制的变化。由于成本成为医院运行中最关注的问题,会使医院减少不必要的药品和耗材,减少病人的看病支出。未来,药品和耗材的购销机制也会发生相应的变化。”张振忠说。

DRG收付费改革是牵动整个卫生行业的系统工程

我国《关于城市公立医院综合改革试点的指导意见》《健康中国2030规划》《“十三五”深化医药卫生体制改革规划》以及2017年最新出台的《国务院办公厅关于进一步深化基本医疗保险支付方式改革的指导意见》等文件中均提出要探索、试行DRG支付方式改革。

今年6月,国家卫计委在深圳召开了DRG收付费改革试点的启动会,确定在深圳、三明、克拉玛依市以及福建省的3家医院共计36家医疗机构开展DRG试点工作。

国家卫生计生委副主任马晓伟在大会致辞中说,国内外经验证明,收付费改革是连接患者、医疗机构和政府补偿的重要政策枢纽,对规范医疗服务行为、推进医疗药品领域改革起到了重大作用。“实践表明,DRG收付费是现代化的卫生经济管理的工具,是对住院病人直接管理的有效方式。DRG收付费改革是一项牵动整个卫生行业的系统工程,对卫生信息的基础建设、卫生标准的统一规范、医疗机构的诊疗行为,促进以成本为核心的动态价值调整机制,都将起到积极的作用。”马晓伟说。

财政部社会保险司副巡视员祖国英表示,国内外实践经验表明,DRG支付在控制医疗费用不合理增长、促进医疗机构降低成本、提高医疗服务质量等方面发挥了积极作用。

收付费方式改革是深化医改、促进三医联动改革最重要最有效的抓手

据国家卫计委体制改革司副司长庄宁介绍,去年中共中央国务院发布的《“健康中国”2030规划纲要》旗帜鲜明地提出要建设整合型的服务体系。庄宁认为,支付方式改革,特别是DRG的改革,对于完成对以医院为中心的服务模式的重构非常重要。

庄宁说:“从服务供给来看,这几年的医疗服务量是井喷式的,但是医疗服务的增长远远没有跟上需求的增长速度。现阶段,我们要更好地把服务体系内部的资源利用好,提高绩效,保证最大的服务供给,才能够在相对资源不足的情况下,解决服务量过度增长的问题。”

去年召开的全国卫生与健康大会,突出强调了要健全医保支付机制,改革医保支付方式。今年,收付费改革已列入了医改的重点工作任务,并提出要在有条件的地区开展DRG收付费改革的试点工作。近期,国务院办公厅印发了《关于进一步深化基本医疗保险支付方式改革的指导意见》55号文,标志着医改有了更加明确的任务和方向。国家卫计委财务司副司长樊挚敏表示,收付费方式改革是深化医改、促进三医联动改革最重要最有效的抓手。改革收付费方式来规范医疗服务行为,对推进医疗药品领域的改革可以起到重要作用。

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