Research on the Key Relationships of Medical Insurance Payment Reform:Taking Shanghai as an Example
- VernacularTitle:医保支付方式改革的关键关系研究
- Author:
Jiajie XU
1
;
Dawei LÜ
;
Bifan ZHU
Author Information
1. 上海市卫生和健康发展研究中心·上海市医学科学技术情报研究所 上海 200040
- Publication Type:Journal Article
- Keywords:
medical insurance payment system reform;
global budget;
DRG;
Diagnosis-Intervention Packet;
Shanghai
- From:
Chinese Hospital Management
2025;45(7):30-33
- CountryChina
- Language:Chinese
-
Abstract:
The reform of medical insurance payment serves as a crucial mechanism for regulating healthcare service practices and guiding the allocation of medical resources.It plays an essential role in ensuring equitable access to high-quality medical services while enhancing the quality and efficiency of medical insurance funds.It analyzed the relationship between national specification and local adjustment,the relationship between global budget management and payment methods,the relationship between DRG/Diagnosis-Intervention Packet and multiple payments,and the relationship between process management and regular settlement in the process of promoting medical insurance payment reform in Shanghai.It also proposed policy suggestions for relationships that need to be further straightened out,to provide reference for the establishment of effective and efficient medical insurance payment mechanism.
