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云南医保支付全面推行按病种付费

2017-09-24 佚名 新华网

为进一步合理控制医疗费用,减轻患者负担,云南省近日起全面推行以按病种付费为主的多元复合式医保支付方式。按新规,各州、市实行按病种收费和付费的病种不少于100个

为进一步合理控制医疗费用,减轻患者负担,云南省近日起全面推行以按病种付费为主的多元复合式医保支付方式。按新规,各州、市实行按病种收费和付费的病种不少于100个。

按病种付费模式,是指通过统一的疾病诊断分类,科学地制定出每一种疾病的定额偿付标准,社保机构按照该标准与住院人次向定点医疗机构支付住院费用,而病人只需按个人支付标准支付相应费用,不需支付其他费用。

另外,云南还将开展按疾病诊断相关分组(DRGs)付费试点,鼓励各地完善按人头、按床日等多种付费方式。

按疾病诊断相关分组(DRGs)付费试点是按病种付费模式的细化,核心是在确保医疗质量安全的前提下,根据疾病严重程度、治疗难易程度和资源消耗程度,用合理的诊疗方法治愈患者疾病。

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