目的: 分析各地中医优势病种纳入DRG/DIP付费的实践情况,探索符合中医药特点的支付方式。方法: 收集梳理21个DRG/DIP地区中医病种付费改革相关政策,并对中医优势病种遴选、支付标准、监管考核、病种特征等进行规范分析。结果: 各地优先将国家发布的中医优势病种纳入按病种付费范围,在支付标准设定上给予倾斜,以合理体现中医药服务的技术劳务价值等。从病种特征来看,共纳入647个中医病种,集中度较高的为“锁骨骨折”等骨科类病种。结论: 中医优势病种按病种付费对中医药发展有积极的支持作用,但目前各地支付标准确定有所差异,建议对中西医病种对应关系及支付标准进一步明确规范。

Objective: The paper analyzed the practice of incorporating dominant traditional Chinese medicine (TCM) diseases into DRG/DIP payment in various regions, and explored payment methods that are in line with the characteristics of TCM. Methods: The study collected policies related to the payment reform of dominant TCM diseases in 21 DRG/DIP regions, and analyzed the selection of dominant TCM diseases, payment standards, regulatory and assessment, and disease characteristics. Results: It was found that various regions prioritize incorporating the national dominant TCM diseases into the scope of payment based on disease types, and give preferential treatment in the setting of payment standards to reasonably reflect the technology and labor value of TCM services. From the perspective of disease characteristics, a total of 647 dominant TCM diseases was included in various regions, among which the orthopedic diseases such as clavicle fractures are common. Conclusions: The payment of dominant TCM diseases based on the disease type presents positive support for the development of TCM. However, the payment standards are different between these regions. It is recommended to further clarify and standardize the corresponding relationship and payment standards between TCM and western medicine disease types.