目的: 对我国各地日间化疗医保管理政策进行系统梳理与分析,明确医保支付现状和存在的问题,为后续完善支付政策提供依据。方法: 以“日间化疗”“日间服务”等为关键词检索全国各省市人社厅、医保局等官方网站,对2013年1月—2023年1月发布的相关政策文件进行筛选与总结分析,并从医保、医疗机构、患者角度探讨日间化疗医保管理发展方向。结果: 当前针对日间化疗出台医保支付相关政策的地区较少,通常作为住院医疗服务纳入医保支付范围,多数地区采用按单病种付费或按DRG/DIP付费方式。结论: 日间化疗符合国家医改方向,各地应在规范化管理的前提下不断完善医保支付方式。

Objective: The paper summarizes and analyzes the policy implementation for ambulatory chemotherapy payment methods in various regions in China, explores the current situation and problem of medical insurance payment to provide support for payment policy of ambulatory chemotherapy. Methods: Using ambulatory chemotherapy, day services as key words, we search the local human resources and social security departments, healthcare security departments. The relevant policy documents released from January 2013 to January 2023 were selected and summarized. On this basis, the future development direction of medical insurance management of ambulatory chemotherapy from the perspective of medical insurance, medical institutions and patients were discussed. Results: There are only a few regions that have issued medical insurance management policies for ambulatory chemotherapy. Ambulatory chemotherapy is usually included in the scope of medical insurance payment as inpatient medical services. In most regions, ambulatory chemotherapy is included in the management of single disease or DRG/DIP payment. Conclusion: Ambulatory chemotherapy conforms to the direction of the national medical reform. All regions should improve the payment method of medical insurance for ambulatory chemotherapy under the premise of standardized management.