价值医疗导向的医保支付方式初探——以中美典型按价值付费项目为例

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英文篇名：Preliminary Study on the Value-based Medical Insurance Payment Method——Taking the Typical Value-based Payment Project between China and the United States as An Example 作者：王思敏 ; 徐伟 ; 崔子丹 ; 施琼华 英文作者：WANG Si-min;XU Wei;CUI Zi-dan;SHI Qiong-hua;School of International Pharmaceutical Business, China Pharmaceutical University; 关键词：按价值付费 ; 医保支付方式 ; 价值医疗 英文关键词：Value-based payment;;medical insurance payment method;;value medical 中文刊名：WSJJ 英文刊名：Health Economics Research 机构：中国药科大学国际医药商学院; 出版日期：2019-02-08 07:00 出版单位：卫生经济研究 年：2019 期：v.36;No.382 语种：中文; 页：WSJJ201902004 页数：4 CN：02 ISSN：33-1056/F 分类号：11-14

摘要

按价值付费是通过质量评价体系和奖惩机制来激励医疗服务提供者提高医疗质量、改善患者就医体验、减少不必要医疗费用的一种新型支付方式。本文阐述了按价值付费的内涵与意义,从筹资与支付模式、医疗质量评价体系、绩效得分评价方法三个角度对比分析了美国Mediacre"以价值为本的医疗服务购买项目"和我国浙江省"肝移植术按绩效付费项目"的异同,以期为我国医保支付方式改革提供借鉴。
        Paying by value is a new type of payment method that encourages medical service providers to improve medical quality, improve patient medical experience, and reduce unnecessary medical expenses through quality evaluation system and reward and punishment mechanism. This paper expounded the connotation and significance of value-based payment, and compared the similarities and differences between the US Mediacre "value-based medical service purchase project" and Zhejiang Province in China "liver transplantation according to performance-paying projects" from the perspectives of financing and payment model, medical quality evaluation system and performance score evaluation method, in order to provide reference for the reform of China's medical insurance payment methods.

引文

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