德国的G-DRG医保支付制度及对我国的启示被引量：36

Germany's G-DRG Payment System and the Implications for China

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摘要通过研究德国实施DRGs支付制度的成功经验,对德国住院医保支付方式—G-DRG的改革历程、支付系统组成、支付费用计算、费用谈判机制与医疗费用审核等方面进行研究,为我国医保支付方式改革提供借鉴。德国的G-DRG实施过程较为缓和,各利益相关体的参与度与认可度较高,医保费用的控制结果较为明显。我国的医保支付改革应循序渐进,同时注意建立病人分类系统、保障临床病例资料的质量以及构建医疗费用审查机制。 Through researching Germany＇s successful experiences of implementing DRGs payment system, the reform process ofG-DRG, the constitution of payment system, payment calculation, expense negotiation mechanism and medical expense audition, so asto provide references for the reform of China＇s medical insurance payament. The implementation process of Germany＇s G-DRG wasrelatively calm, the stakeholder bodies were well-pleasing involvement and acceptance. The controlling results of medical insurancewere obvious. Medical insurance payment reform should be gradual in China. Meanwhile, it needed to pay attention to establish the pa-tient classification system, ensure the quality of clinical data and build the reviewing mechanism for health care expense.

作者常峰纪美艳路云

机构地区中国药科大学国际医药商学院

出处《中国卫生经济》北大核心 2016年第6期92-96,共5页 Chinese Health Economics

关键词 G-DRG 分类系统协商机制费用审查 G-DRG classification system consultation mechanisms expense review

分类号 F845.16 [经济管理—保险] F842.684 [经济管理—保险]

作者简介常峰（1972-），男，博士学位。副教授：研究方向：药品价格规制、医疗保障和医药流通体系研究：E-mail：cpucf@163．com, 通讯作者：纪美艳，E-mail：jizimo@163．com.

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