通过应用病例组合指数（CMI）原则,研究人员开发了一种新型的医院支付及管理系统,称为基于大数据的按病种分值付费(以下简称DIP),其分组过程是基于ICD-10和ICD-9-CM-3编码的一种独特组合。它是根据上海市的出院记录开发的,之后在广州市开展了医保付费试点工作。试点评估结果显示,这一管理系统可节省约5%的医院预算,并显著提高医疗服务效率。医院监管调控工具的完善,可有效识别潜在的医院违规行为,以便开展进一步的审计和调查工作。与其他支付模式相比,DIP平台在组内资源利用均匀度、设计简单性、动态调整分组等方面具有诸多优势。

We developed a novel hospital payment, management system called Big Data Diagnosis & Intervention Packetby applying the case mix indexprinciples but the grouping is based on unique combination of ICD‐10, ICD‐9v3codes. The initial prototype of BD‐DIP was developed using hospital discharge records in Shanghai, then piloted in Guangzhou, China. Results from the pilot evaluation showed that introduction of the BD‐DIP lead to about5% hospital budget savings, notable improvement in hospital care efficiency. The implementation of hospital monitoring tools resulted in identification of potential irregular practices to enable further auditing, investigation. The BD‐DIP platform has a number of advantages over other payment models in terms of more homogeneous resource utilization within groups, design simplicity, dynamic in grouping