摘要
医保支付制度是医疗保障制度的重要组成部分,新时代我国医保支付方式也作出了调整,疾病诊断相关分组(DRG)和按病种分值付费(Diagnosis-Intervention Packet,DIP)逐步推广,提升资源配置效率的同时也给医患关系带来了新的挑战,医患矛盾出现了新特征。通过回顾医患矛盾的缘起和变迁,总结其与制度的关系,结合我国医药卫生体制改革并通过文献梳理与案例分析,探寻在DRG/DIP支付背景下医患矛盾的新特征及其成因,从完善支付政策设计、利益平衡、人文教育与舆论监管、诊疗同质化等角度出发,针对医患矛盾新特征提出治理方案,以期实现新医保支付方式改革下医患关系的和谐与医疗服务效率双赢的目标。
The medical insurance payment system is an essential component of the healthcare security system.In the new era,China has adjusted its medical insurance payment methods,gradually promoting Diagnosis Related Groups(DRG)and Diagnosis-Intervention Packet(DIP)payment systems.While enhancing resource allocation efficiency,these reforms have also introduced new challenges to the doctor-patient relationship,leading to new characteristics in doctor-patient conflicts.It reviews the origins and evolution of such conflicts,summarizes their relationship with institutional changes,and examines China’s healthcare reform through literature review and case analysis.It explores the new characteristics and causes of doctor-patient conflicts under the DRG/DIP payment context.From perspectives such as improving payment policy design,strengthening accountability and balancing interests,promoting humanistic education and media supervision,and ensuring consistency in medical treatment,the paper proposes governance solutions to address the new characteristics of doctor-patient conflicts.The aim is to achieve a dual goal of harmonious doctor-patient relationships and improved medical service efficiency under the reformed payment system.
作者
赵麒然
迟方旭
Zhao Qiran;Chi Fangxu(School of law,Lanzhou University,Lanzhou,Gansu,730000,China;不详)
出处
《中国医院管理》
北大核心
2025年第3期83-86,共4页
Chinese Hospital Management
基金
甘肃省人大常委会地方立法研究课题(纵20200028)。
关键词
疾病诊断相关分组
按病种分值付费
医疗保险
医患矛盾
医药卫生体制改革
Diagnosis Related Groups
Diagnosis-Intervention Packet
medical insurance
doctor-patient conflicts
medical and health system reform
