基于DRG支付体系的浙江省国谈药品落地政策研究与改进策略

Research and Improvement Strategies on the Policy of National Reimbursement Negotiation Drugs' Implementation in Zhejiang Province under the DRG Payment System

关键词:  DRG  国谈药品  落地政策

Key words:  DRG  national reimbursement negotiation drugs  policies for implementation

摘要:

摘要：目的 本文旨在研究和分析浙江省DRG支付体系下国谈药品的落地政策，并探讨改进策略以提高国谈药品的可及性和使用效率。方法 通过文献回顾和政策分析，本文详细考察了浙江省DRG支付体系的背景、特点以及国谈药品在浙江省医疗机构落地的挑战。同时，对比分析了外省的DRG对国谈药品的配套政策，并梳理了浙江省内不同统筹区的DRG支付/补偿机制。结果 浙江省DRG支付体系在控制医疗费用方面有一定成效，但国谈药品落地面临诸多挑战，如公立医疗机构绩效考核、药品纳入用药目录流程复杂、DRG对病组补偿不足等；外省的国谈药品单列支付政策提供了借鉴；浙江省各统筹区DRG补偿机制需进一步优化。建议 完善DRG对国谈药品病组的测算体系、实施国谈药品单列支付政策、优化DRG补偿机制，以提高国谈药品的可及性和患者的治疗选择。

Abstract:

ABSTRACT: OBJECTIVE The purpose of this paper is to study and analyze the implementation policies of Reimbursement Negotiation Drugs(NRND) under the DRG payment system in Zhejiang Province, and to explore strategies for improvement to enhance the accessibility and utilization efficiency of NRND.METHODS Through literature review and policy analysis, this paper thoroughly examines the background and characteristics of the DRG payment system in Zhejiang Province, as well as the challenges faced by the implementation of NRND in medical institutions in Zhejiang Province. At the same time, it compares and analyzes the supporting policies for NRND under the DRG system in other provinces, and combs the DRG payment/compensation mechanisms in different pooling areas within Zhejiang Province.CONCLUSION The DRG payment system in Zhejiang Province has achieved certain effects in controlling medical expenses, but the implementation of NRND is facing many challenges, such as performance assessment of public medical institutions, the complex process of including drugs in the drug directory, and insufficient compensation for disease groups under DRG.The separate payment policies for NRND in other provinces provide a reference;the DRG compensation mechanisms in various pooling areas of Zhejiang Province need further optimization.SUGGESTIONS Improve the calculation system for the DRG groups of NRND,implement a separate payment policy for NRND,and optimize the DRG compensation mechanism to enhance the accessibility of NRND and the treatment options for patients.