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DRG改革背景下的负向医疗行为及其治理路径

杨晓霞

中国农村卫生事业管理2024,Vol.44Issue(4):275-279,5.
中国农村卫生事业管理2024,Vol.44Issue(4):275-279,5.DOI:10.19955/j.cnki.1005-5916.2024.04.008

DRG改革背景下的负向医疗行为及其治理路径

Negative medical behavior and its governance path under the background of DRG payment reform

杨晓霞1

作者信息

  • 1. 南京市第二医院,江苏南京 210003
  • 折叠

摘要

Abstract

With the original intention of reducing the cost of medical treatment for the public and impro-ving the quality of medical services,the reform of DRG payment system has been continuously promoted and im-plemented in China.While achieving the goals of standardizing medical behaviors,optimizing clinical pathways,and implementing graded diagnosis and treatment,there were still negative medical behaviors,which included pa-tient shifting,reduced quality,demand induction,and deliberate diversion of patients into costly disease groups,among hospitals and medical workers due to factors such as industry pressure transmission,misaligned subject in-formation,and insufficient regulatory mechanisms.Such is not conducive to the original effectiveness of DRG pay-ment system.Therefore,it is necessary to further enhance the standardization of DRG payment management,strengthen the information platform monitoring system,optimize the hospital operation and management mode,so as to better safeguard the legitimate rights and interests of patients,hospitals,medical insurance institutions and other parties,and continuously promote the healthy development of the pharmaceutical and healthcare industry.

关键词

DRG改革/医保基金/负向医疗行为/医疗服务/完善监管/质量提升/运营管理

Key words

DRG reform/Medical insurance funds/Negative medical behavior/Medical services/Im-proved regulation/Quality improvement/Operation management

分类

医药卫生

引用本文复制引用

杨晓霞..DRG改革背景下的负向医疗行为及其治理路径[J].中国农村卫生事业管理,2024,44(4):275-279,5.

中国农村卫生事业管理

1005-5916

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