按病种支付医疗保险费用与病种成本核算研究

医疗服务具有垄断性、委托代理双重性和需求刚性.在利益机制驱动下,医疗项目的选择变成供方偏好,是医疗费用快速攀升的症结之一.变按项目支付为按病种支付,是控制医疗费用快速上涨、深化卫生改革的重要措施之一.最科学的方法是进行病种成本核算.

Research on the Medicare Payment and Cost Accounting Based on Diagnosis Related Group Diseases

From the perspective of economics, medical services are characterized by monopolization, the dual nature of entrustment and agency and the inflexibility of demands. Driven by the pursuit of profits, suppliers are keen on the kind of medical programs they provide, leading in part to the excessively rapid increase of medical cost. One of the key measures for checking this increase and deepening health reform is to replace programs with payment by case groups. It is a key tache to make disease payment standard, the most scientific way is to popularize the cost of diseases using the DRGS.