摘要
建立高值医用耗材医保准入制度,实行高值医用耗材目录管理,是我国高值医用耗材治理的重要环节。本文在梳理国内高值医用耗材医保准入现状的基础上,深入剖析了日本、法国等国家或地区高值医用耗材医保准入机制,重点从医保目录管理、支付标准制定、疾病诊断相关分组(DRG)付费衔接三个方面进行分析,旨在为我国构建高值医用耗材医保目录管理制度提供借鉴。
Establishing and improving the medical insurance access system for high-value medical consumables and implementing the management of high-value medical consumables catalogs are important links in the management of high-value medical consumables in China.Based on the review of the current status of medical insurance access for domestic high-value medical consumables,this article deeply analyzes the medical insurance access mechanism for high-value medical consumables in Japan,France and other countries or regions,focusing on medical insurance catalog management,payment standard formulation and disease diagnosis related groups(DRG)so as to provide a reference for China to build a medical insurance access system for high-value medical consumables.
作者
丁锦希
黄新锋
李伟
李佳明
任雨青
吴秋婷
DING Jinxi;HUANG Xinfeng;LI Wei;LI Jiaming;REN Yuqing;WU Qiuting(China Pharmaceutical University,Nanjing 211198,China)
出处
《上海医药》
CAS
2021年第1期65-69,共5页
Shanghai Medical & Pharmaceutical Journal
基金
2020年江苏省医疗保险研究会项目“医保支付标准引导药品医用耗材价格市场形成机制研究”。
关键词
高值医用耗材
医保目录
医保支付标准
DRG付费
high-value medical consumables
medical insurance catalog
medical insurance payment standard
DRG payment
作者简介
丁锦希,教授,博士生导师。主要研究方向:医药政策法规和药物经济学。E-mail:jinxi_ding@163.com。
