摘要
从经济学视角出发,重新审视了的内涵与原理。利用卫生经济学医疗服务的特点和制度经济学交易成本对DRGs的适用条件进行了分析,即构建权威、统一的疾病分组器,建立科学统一的诊疗标准和临床路径、完善的信息系统和成本核算体系。通过对北京和上海典型地区的案例分析,从一个侧面展现DRGs在开展的现状。最后,基于理论分析和国内现状,提出了我国实施DRGs的建议。
The connotation and principle of DRGs are reviewed from the perspective of health economics. The applicable conditions for DRGs are analyzed by characteristics of healthcare services in health economics and transaction costs in institutional economics, that is, to develop an authoritative and unified disease grouping tool,establish a scientific and unified treatment standards and Clinical Pathway, and improve information system and cost accounting system. The case analysis of Beijing and Shanghai shows the status quo of DRGs conducted in China. Finally,some suggestions are proposed based on theory analysis and domestic situation.
引文
[1]FETTER R B,SHIN Y,FREMAN J L,et al.Case mix definition by diagnosis-related groups[J].Medical Care,1980,18(2):1-53.
[2]简伟研.DRGs系统的发展和应用[M]//邓小虹.北京DRGs系统的研究与应用.北京:北京大学医学出版社,2015.
[3]张五常.经济解释[M].上海:商务印书馆,2000.
[4]王珊,杨兴宇,郎婧婧,等.全国按疾病诊断相关分组收付费在医院的应用探讨[J].中国医院管理,2017,37(6):5-7.
[5]胡广宇,刘婕,付婷辉,等.我国按疾病诊断相关分组预付费改革进展及建议[J].中国卫生政策研究,2017,10(9):32-38.
[6]许岩,孙木,何萍,等.上海市医院疾病诊断分组模型及分组器的建立[J].中国卫生政策研究,2015,8(9):15-18.
[7]郭永瑾,岑珏,许岩,等.疾病诊断分组系统的建立及其在医院绩效管理中的应用[J].中国卫生政策研究,2015,8(9):6-9.
[8]郑启文,刘忆,冷家骅.DRGs在国内外的应用回顾及探讨[J].中国医院,2015,19(6):11-12.