DIP付费方式起源于地方实践,根植于医保基金支付理论,而今在大范围推行,将对医保自身高质量发展、医疗医药供给侧协同发展带来深刻影响。本文基于DIP付费原理及由此形成的一整套支付体系,系统论述DIP的适宜性和有效性。DIP付费的核心特征在于既源于临床实际,基于临床真实世界,反映病种的诊断、操作及资源消耗共性特征,又借助大数据予以必要的校正,并以此主导支付体系的完整构建。在改革实施过程中,要有效避免对于改革阶段性、改革设计初衷、支付本质等方面的认识误区,以确保改革顺利推进,最终取得预期成效。

The DIP payment method originates from local practice and is rooted in the theory of medical insurance fund payment. Nowadays, it is being widely implemented, which will have a profound impact on the high-quality development of medical insurance and the coordinated development and governance of the medical and pharmaceutical supply side. Based on the principle of DIP payment and the corresponding payment system, the paper systematically discusses the suitability and effectiveness of DIP. The core feature of DIP payment is that it not only originates from clinical practice, reflects the common characteristics of disease diagnosis, operation and resource consumption based on the clinical real world, but also makes necessary corrections and the complete construction of the payment system by means of the big data. During the implementation process of reform, it is necessary to effectively avoid misunderstandings about the reform stage, the original intention of reform design, and the essence of payment, in order to ensure the progress of the reform and ultimately achieve the expected results.