文献类型：期刊文献

中文题名：疾病诊断分组与按床日付费有机结合的探索

英文题名：The Combination of Payment by Diagnosis Related Groups and Per-Diem under New Rural Cooperative Medical System

作者：杨敬宇[1,2];宋向嵘[2];谭芙蓉[2];王蓉娟[2]

第一作者：杨敬宇

机构：[1]甘肃中医药大学经管学院;[2]兰州大学公共卫生学院

第一机构：甘肃中医药大学经贸与管理学院

年份：2015

卷号：22

期号：6

起止页码：23

中文期刊名：中国卫生质量管理

外文期刊名：Chinese Health Quality Management

收录：CSTPCD

基金：2013年国家社会科学基金项目:西部少数民族山区(牧区)三级医疗卫生服务网络调查研究(13XMZ031)

语种：中文

中文关键词：新农合;支付方式;按疾病诊断分组;按床日付费

外文关键词：New Rural Cooperative Medical System; Payment Method;Diagnosis Related Groups;PerDiem Payment

摘要：确定付费方式,保证覆盖范围;落实改革配套措施;构建政策环境,加强监督考核;加强医疗服务质量管理;大力开展宣传等。通过上述措施的落实,探索出一条新型的、合理的支付方式改革路径,可最大限度地利用新农合资金,使参合农民受益,推动医保制度持续发展。但其在医疗费用控制有效机制、管理标准细化、信息化建设等方面尚存在问题与不足,需在进一步的探索中加以改进。
Through the implementation of measures, a new, reasonable payment reform path was explored. The measures included determining pay measures and guaranteeing coverage; supporting measures to implement the reform; building policy environment, strengthening supervision and evaluation; strengthening health care quality management; vigorously carrying out publicity. The new rural cooperative funds can be maximize used to enable the benefit of participating farmers and promote the sustainable development of the health insurance system. However, problems still existed in effective mechanism to control medical cost, management standard refinement, information technology and other issues, which needed to be improved in further exploration.