保险学-DRGs付费模式在我国的实践研究论文VIP专享

DRGS 医疗模式在我国实践研究【摘要】医疗改革是现在社会上人们日常关注的热点话题。现在社会上面时不时发生诸如：医疗里患者与医生之间因为医疗费用产生的分歧；医疗保险公司在赔付医疗费用时与被保险人出现的分歧等。而以上这些都是因为医疗机构内部缺乏科学化的管理和相关政府部门没有科学的对策。而 DRGS 也就是在这样的背景下引入国内，同时引入了疾病诊断相关分组的概念。在引入初期也是取得了一系列的研究成果，在经历过一段时间的停滞之后，开始重视 DRGS 的发展。而本文结合中外文献，回顾我国在 DRGS 的发展简史，摘取一些具有代表性的试点城市的研究方案和成果；结合对比研究的方法，介绍国际上前沿国家对于 DRGS的研究思路和相关政策上的作用，分析 DRGS 在我国发展有那些制约因素；结合文献，对于这些不足的地方提出合理科学的建议。【关键词】疾病诊断相关分组；制约因素；医院管理；对策 注：本论文（设计）题目来源于教师的国家级（或省部级、厅级、市级、校级、企业）科研项目，项目编号为： B2019233 。1DRGS medical model in practice in China[Abstract]Health care reform is a hot topic in our society. Now society is full of such things as: medical patients and doctors because of the cost of medical disagreements; The difference that medical treatment insurance company appears with insurant when paying medical treatment cost. All these are due to the lack of scientific management within medical institutions and the lack of scientific countermeasures from relevant government departments. In this context, DRGS was introduced into China, and the concept of disease diagnosis related grouping was also introduced. In the early stage of introduction, a series of research results have been obtained. After a period of stagnation, attention has been paid to the development of DRGS. Combined with Chinese and foreign literatures, this paper reviewed the brief history of China's development in DRGS, and selected the research programs and achievements of some representative pilot...