摘要
中医药价值如何在新医保付费模式下精准体现成为关键。基于“三医”协同视角对浙江省中医医保支付方式改革进行梳理:回顾法规及实践,揭示DRG付费对中医适配不足、次手术编码权重不足、中医服务项目价值低估、中药处方帖费用标准滞后等难题;借鉴沪、粤等地经验,提出细化中医分组、调整权重、完善定价、动态更新中药费用等方案。研究旨在通过优化支付机制提升中医服务可及性与疗效,为中医药高质量发展与现代医疗深度融合提供政策参考。
Accurately reflecting the value of Traditional Chinese Medicine(TCM)within emerging health-insurance payment models has become pivotal.Analyzing Zhejiang Province's TCM medical insurance payment reform from a“three-medicine”synergy perspective:reviewing regulations and practices reveals challenges with DRG payment systems,including inadequate adaptation to TCM,insufficient weighting for minor surgical procedures,undervaluation of TCM service items,and outdated pricing standards for herbal medicine prescriptions.Drawing on experiences from Shanghai,Guangdong,and other regions,it proposes solutions such as refining TCM diagnostic groupings,adjusting weighting factors,improving pricing mechanisms,and implementing dynamic updates for herbal medicine costs.By optimising the payment architecture,it aims to enhance both accessibility and therapeutic effectiveness of TCM services,thereby offering policy guidance for the high-quality development of TCM and its deeper integration into the modern healthcare system.
作者
荣超
刘林
王延隆
佟欣
陈雅静
赵峰
范鹏昊
雷婷婷
张思缘
叶玲伶
黄文秀
Rong Chao;Liu Lin;Wang Yanlong(College of Humanities and Management,Zhejiang Chinese Medical University,Hangzhou,Zhejiang,310053,China;不详)
出处
《中国医院管理》
北大核心
2026年第2期42-45,共4页
Chinese Hospital Management
基金
国家社会科学基金项目(24BSH097)。
关键词
“三医”协同
中医
医保支付方式改革
浙江
“three-medicine”s synergy
Traditional Chinese Medicine
reform of medical insurance payment methods
Zhejiang
