摘要
目的:确定合理的DRG相对权重,确保DRG系统的有效性和公平性。方法:通过文献分析,梳理国内外DRG相对权重谈判现状,以S市为例,介绍我国DRG权重谈判的过程。结果:我国DRG权重谈判仍在学习探索阶段,各统筹区制度建设不健全,未建立成本核算体系,权重调整政策不够完善,临床数据质量不高。结论:各统筹区应加强数据质量监管,建立长期、动态的相对权重更新和调整机制,以及以医疗成本为基础的专家谈判机制和成本核算体系,积极研究相对权重调整方法并出台统一的权重调整方案。
Objective To determine a reasonable DRG relative weight to ensure the effectiveness and fairness of the DRG system.Methods Through literature analysis,the current situation of DRG relative weight negotiation at home and abroad was sorted out.This study took S city as an example to introduce the process of DRG weight negotiation in China.Results DRG weight negotiation in China is still at the stage of learning and exploring,the system construction of each co-ordinating district is not sound,no cost accounting system has been established,the weight adjustment policy is not perfect,and the quality of clinical data is not high.Conclusion Each coordinating region should strengthen data quality supervision,establish a long-term and dynamic mechanism for updating and adjusting relative weights,as well as an expert negotiation mechanism and cost accounting system based on medical costs,actively study relative weight adjustment methods and introduce a unified weight adjustment scheme.
作者
李婵
邹佳
徐焦
李璠
LI Chan;ZOU Jia;XU Jiao;LI Fan(School of Pharmaceutical Science and Yunnan Provincial Key Laboratory of Pharmacology for Natural Products,Kunming Medical University,Kunming Yunnan 650500,China)
基金
云南省药物政策研究中心课题项目“以医保药品政策为抓手促进云南省生物医药产业发展路径研究”(2020YNPP001)。
关键词
疾病诊断相关分组
相对权重
权重谈判
动态调整
Diagnosis Related groups
relative weight
weight negotiation
dynamic adjustment
