通讯作者: 项莉, xllyf@126.com

DOI：10.12201/bmr.202406.00024

Research on the Impact of Supply Side Policy Collaboration of Medical Insurance on Cost Control under DIP Payment

• 摘要：目的：DIP支付方式作为医保供给侧改革重要组成部分,本研究旨在探索其与其他医保供给侧政策间的协同效果。方法：以全国DIP改革试点城市A市为处理组,未改革城市B市为对照组进行比较研究。收集2019-2022年共计1120个公立医疗机构样本,对住院医疗总费用及部分费用结构进行双重差分法分析。结果：A市对医疗机构的住院医疗总费用、住院检查化验总费用产生显著的抑制效应(P<0.05),对住院药品总费用和住院材料总费用未产生影响。结论：DIP支付方式发挥显著控费效果,住院医疗总费用有效控制；调价政策与集采政策协同,对控费效果尚有不足；DIP与其他供给侧政策协同,促进医疗费用结构合理。建议医保部门注重医保供给侧政策协同作用,共同推动医保基金使用效率提升。

  关键词： DIP支付方式; 供给侧改革; 医疗服务价格调整; 药品/耗材集中采购

   

  Abstract: Objective: DIP payment is an important component of Chinas medical insurance supply-side reform. This study aims to explore the synergistic effects of DIP and other medical insurance supply-side policies. Method: A city A that has piloted DIP reform was set as the treatment group, and a city B without reform was set as the control group. A total of 1,120 public medical institution samples from 2019 to 2022 were collected. The total medical expenses during hospitalization and some structural expenses were analyzed using the double difference method. Result: DIP had a significant inhibitory effect on the total medical expenses during hospitalization and the total expenses of checkups and examinations during hospitalization in city A (P<0.05), but had no impact on the total drug expenses and the total material expenses during hospitalization. Conclusion: DIP played a significant cost control role and effectively controlled the total medical expenses during hospitalization. The collaborative effects of price adjustment of medical services policy and national centralized drug/material procurement policy on cost control were insufficient. DIP synergized with other supply-side policies to promote rational medical cost structure. It is suggested that medical insurance departments should focus on the synergistic effects of medical insurance supply-side policies to jointly improve the efficiency of medical insurance fund utilization.

  Key words: DIP payment; Supply side reform; Price adjustment of medical services policy; national centralized drug/material procurement policy

  提交时间：2024-06-17

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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  林坤河, 刘宵, 熊英贝, 姚轶凡, 项莉. DIP支付方式与紧密型医共体总额付费政策融合探索. 2023. doi: 10.12201/bmr.202305.00002

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  王彪, 张天天, 唐啸宇, 贾韵, 罗力. 国家组织药品带量采购政策的降价持续性研究. 2023. doi: 10.12201/bmr.202305.00008

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  王彪, 张天天, 唐啸宇, 贾韵, 罗力. 我国集中带量采购中选药品价格的差异及区域分布研究. 2023. doi: 10.12201/bmr.202306.00008

  郑炆苅, 邓清文, 夏宇, 刘柳, 陈英耀, 杨毅. 政策工具视角下我国医保支付体系政策文本分析. 2024. doi: 10.12201/bmr.202402.00006

• 序号	提交日期	编号	操作
  1	2024-03-16	bmr.202406.00024V1	下载

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