目的：通过对DRG分组原理与结算管理办法的进一步研究分析,探索适合专科医疗机构自身特点的本地化结算管理方案。方法：通过DRG运行期间部分效能指标的横向与纵向比对,分析专科医院在DRG支付方式下的受限因素与差异原因。结果：儿童、中医等专科医院,因患者构成情况、收费定价及治疗原理、方案差异性等因素影响,在DRG付费体系下,存在整体收益盈亏难以平衡和专业特色不能在分组方案中充分体现等情况。结论：应建立符合专科特色的绩效激励机制和高效协同机制,进一步激发专科医疗机构参与DRG付费改革的积极性,推动其提升数据质量水平,持续优化绩效分配机制。

Objective: Through further research and analysis of DRG grouping principle and settlement management methods, this paper explores a localized settlement management scheme suitable for the characteristics of specialized medical institutions. Methods: Through the horizontal and vertical comparison of some performance indicators during the operation of DRG, this paper analyzes the restrictive factors and differences of specialized hospitals under DRG payment mode. Results: Children's Hospital, traditional Chinese medicine hospital and other specialized hospitals, due to the influence of patient composition, charge pricing and treatment principle, scheme differences and other factors, under the DRG payment system, the overall profit and loss is difficult to balance, and the professional characteristics can not be fully reflected in the grouping scheme. Conclusion: We should establish a performance incentive mechanism and efficient coordination mechanism in line with the characteristics of specialty, further stimulate the enthusiasm of specialty medical institutions to participate in DRG payment reform, promote them to improve the level of data quality and continuously optimize the performance distribution mechanism.