摘要
深圳罗湖区在医院集团实施"结余奖励,超支不补,合理分担"的总额管理模式,持续加强协作、优化服务、降低成本、改善群众健康水平。作者运用博弈论构建罗湖总额模式下医院集团博弈模型,讨论医疗卫生机构合作强化的原因及罗湖模式可以改进的方面;借鉴罗湖总额预算管理经验,建议各地实施总额预算时应完善闭环管理、扩大覆盖面、采取复合型医保支付方式、推进门诊统筹、强化考核激励,从而充分发挥总额预算的激励作用。
Luohu District of Shenzhen has implemented the global budget management mode as"surplus reward,no compensation for overspending and reasonable sharing"in the hospital group,which continued to strengthen cooperation,optimize services,reduce costs,and improve health outcomes.The authors employed the game theory to build a game model of medical alliance under Luohu global budget management mode,discussing the reasons of medical and health institution′s stronger cooperation and what could be improved in Luohu′s case.Based on the experience of Luohu total budget management,it is suggested that when implementing total budget,all localities should improve closed-loop management,expand coverage,adopt compound medical insurance payment method,promote outpatient coordination,strengthen assessment and incentives,so as to give full play to the incentive role of total budget.
作者
黄雨萌
吴文琪
钟正东
刘宵
林坤河
项莉
Huang Yumeng;Wu Wenqi;Zhong Zhengdong;Liu Xiao;Lin Kunhe;Xiang Li(Tongji Medical College of Huazhong University of Science and Technology,School of Medicine and Health Management,Wuhan 430030,China)
出处
《中华医院管理杂志》
CSCD
北大核心
2021年第12期969-973,共5页
Chinese Journal of Hospital Administration
基金
国家自然科学基金(71874058)。
关键词
总额预算
医疗联合体
合作
博弈论
Global budget
Medical alliance
Cooperation
Game theory