摘要
2019年国家医保局颁发《关于印发按疾病诊断相关分组付费国家试点城市名单的通知》,确定在全国选择30个城市作DRG付费改革试点,2020年模拟运行,2021年全面实行,武汉市被列为试点名单。武汉大学中南医院作为武汉市DRG的试点医院,为了应对DRG支付改革,在传统考核指标的体系上,科学性地加入DRG支付的“CMI增速”、“DRG均次费用增速”两项指标。笔者基于武汉大学中南医院近3年医保数据,通过介绍医院医保绩效考核构建及运用过程,探讨DRG支付下医院医保绩效考核新思路。
In 2019,the National Medical Insurance Administration issued the“Notice on Printing and Distributing the List of National Pilot Cities Paying by Disease Diagnosis Related Groups”,and determined that 30 cities across the country will be selected as DRG payment reform pilots.The simulation will run in 2020,and it will be fully implemented in 2021.Wuhan is listed For the pilot list.As a pilot hospital for DRG in Wuhan,Wuhan University Zhongnan Hospital,in response to the DRG payment reform,has scientifically added the two indicators“CMI growth rate”and“DRG average cost growth rate”in the traditional assessment indicator system.Based on the medical insurance data of Zhongnan Hospital of Wuhan University in the past three years,the author introduces the construction and application process of hospital medical insurance performance evaluation,and explores new ideas for hospital medical insurance performance evaluation under DRG payment.
作者
陈驰昂
郭广炜
曾红莉
CHEN Chiang;GUO Guangwei;ZENG Hongli(Zhongnan Hospital,Wuhan University,Wuhan 430071,China)
出处
《现代医院》
2021年第3期395-398,共4页
Modern Hospitals
基金
武汉大学中南医院2020年度医院管理研究项目(2020-Q-68)。
关键词
DRGS
绩效考核
医疗保险管理
武汉市
DRGs
Performance appraisal
Medical insurance management
Wuhan
