WU Fanfan, LIN Peng, XU Aijun, QIAO Xuebin. Comparative Study on Typical Models of Traditional Chinese Medicine Medical Insurance Payment Reform in China[J]. Journal of Nanjing University of traditional Chinese Medicine(Social Science Edition), 2024, 25(4): 211-217. DOI: 10.20060/j.cnki.ISSN1009-3222.2024.0211
Citation: WU Fanfan, LIN Peng, XU Aijun, QIAO Xuebin. Comparative Study on Typical Models of Traditional Chinese Medicine Medical Insurance Payment Reform in China[J]. Journal of Nanjing University of traditional Chinese Medicine(Social Science Edition), 2024, 25(4): 211-217. DOI: 10.20060/j.cnki.ISSN1009-3222.2024.0211

Comparative Study on Typical Models of Traditional Chinese Medicine Medical Insurance Payment Reform in China

More Information
  • Received Date: February 08, 2024
  • Available Online: July 21, 2024
  • Starting from a comparative research perspective, this article analyzes and sorts out the typical models of the reform of three traditional Chinese medicine medical insurance payment methods in China, providing a basis and reference for optimizing the payment methods of traditional Chinese medicine medical insurance in the future. Nanjing City is implementing DRG (Diagnosis Related Groups) traditional Chinese medicine grouping, Liuzhou City is implementing payment based on the therapeutic value of advantageous diseases in traditional Chinese medicine, and Hangzhou City is implementing a payment tilt policy for traditional Chinese medicine medical services based on the "treatment rate". The three regions have tried different approaches and formed different reform models for traditional Chinese medicine medical insurance payments, playing a pioneering and exemplary role in promoting the development of traditional Chinese medicine. Through comparison, it can be concluded that the reform of traditional Chinese medicine medical insurance payment methods needs to grasp the essence of the advantages of traditional Chinese medicine, and introduce payment methods that reflect traditional Chinese medicine elements and combine multiple paths based on local conditions, in order to promote the development of traditional Chinese medicine and the high-quality development of traditional Chinese medicine hospitals.

  • [1]
    王森, 曹颖, 徐小军, 等. 对基于中医药特点的医保支付方式改革的思考[J]. 药品评价, 2022, 19(13): 769-772. https://www.cnki.com.cn/Article/CJFDTOTAL-YPPJ202213001.htm
    [2]
    刁仁昌, 薛虹, 吴尚勇. 江苏南京中医DRG的分组逻辑与改革成效[J]. 中国卫生, 2022(8): 61-64. https://www.cnki.com.cn/Article/CJFDTOTAL-WSZG202208025.htm
    [3]
    王大壮, 喻小勇, 李天鹏, 等. 南京DRG点数法付费在中医医院的实施效果及其完善策略探析: 以某省三甲中医院为例[J]. 中国卫生事业管理, 2023, 40(3): 165-167. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWSG202303002.htm
    [4]
    李静, 张晓琴, 陈友娴. 南京市DRG点数法付费在中医院管理中的实践及思考[J]. 卫生软科学, 2022, 36(9): 6-10. https://www.cnki.com.cn/Article/CJFDTOTAL-WRKX202209002.htm
    [5]
    柳州市卫生健康委员会柳州市中医药发展"十四五"规划(2021年—2025年)[EB/OL]. (2023-01-24)[2024-06-12]. http://wjw.liuzhou.gov.cn/zwgk/fdzdgknr/ghjh/zcqgh/202310/t20231023-3361002.shtml.
    [6]
    于淼, 宋琦, 杨燕绥, 等. 中医按病种分值医保付费政策效果分析及经验总结[J]. 中国卫生政策研究, 2023, 16(5): 34-40. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWZ202305006.htm
    [7]
    廖藏宜, 秦纪华, 蓝志成. 中医优势病种按疗效价值付费的柳州经验[J]. 卫生经济研究, 2023, 40(6): 61-63, 67. https://www.cnki.com.cn/Article/CJFDTOTAL-WSJJ202306016.htm
    [8]
    廖藏宜. DRG时代中医疗效价值付费的理念与政策架构[J]. 中国人力资源社会保障, 2021(5): 59. https://www.cnki.com.cn/Article/CJFDTOTAL-BZLD202105033.htm
    [9]
    杭州市卫生健康委杭州市发展改革委关于印发《杭州市中医药发展"十四五"规划》的通知[EB/OL]. (2021-10-14)[2024-06-15]. https://www.hangzhou.gov.cn/art/2021/10/14/art_1229541463-3946398.html.
    [10]
    石连忠, 梅彦, 余震, 等. 杭州市DRG中医支付政策的实践探索[J]. 卫生经济研究, 2021, 38(12): 16-19. https://www.cnki.com.cn/Article/CJFDTOTAL-WSJJ202112005.htm
    [11]
    王少君, 廖藏宜, 徐梦秋, 等. 浙江: DRG支付体系下的中医倾斜机制[J]. 中国卫生, 2022(12): 90-91. https://www.cnki.com.cn/Article/CJFDTOTAL-WSZG202212047.htm
    [12]
    戴朝明, 李虎石, 张丽, 等. DRG支付之下中医医院需要正向激励[J]. 中国卫生, 2022(8): 75-77. https://www.cnki.com.cn/Article/CJFDTOTAL-WSZG202208030.htm
    [13]
    浙江省医疗保障局等四部门关于完善中医药医保支付政策的通知[J]. 浙江省人民政府公报, 2023(2): 34-35.
    [14]
    廖藏宜, 杨若宁, 廖俏敏, 等. DRG/DIP付费下中医药医保支付改革的现实困境、典型经验及政策建议[J]. 中国现代中药, 2024, 26(5): 765-773. https://www.cnki.com.cn/Article/CJFDTOTAL-YJXX202405001.htm
    [15]
    张立强, 李强, 李欣芳, 等. 价值视角下体现中医元素的支付方式改革实践与思考[J]. 中国卫生经济, 2023, 42(2): 1-5. https://www.cnki.com.cn/Article/CJFDTOTAL-WEIJ202302001.htm
    [16]
    张弘, 丁科, 谢俊明, 等. "疗效价值付费"下的中医优势病种DRG付费方案探索[J]. 卫生经济研究, 2021, 38(12): 75-76. https://www.cnki.com.cn/Article/CJFDTOTAL-WSJJ202112022.htm

Catalog

    Article Metrics

    Article views (175) PDF downloads (500) Cited by()
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return