我国DRG/DIP支付方式改革政策的发展特征研究——基于231份政策文本的量化分析

杨华磊, 胡慧娟, 李双双, 唐丽丽, 曹顺子

中国医疗保险 ›› 2024, Vol. 0 ›› Issue (9) : 70-78.

中国医疗保险 ›› 2024, Vol. 0 ›› Issue (9) : 70-78. DOI: 10.19546/j.issn.1674-3830.2024.9.010
观察思考

我国DRG/DIP支付方式改革政策的发展特征研究——基于231份政策文本的量化分析

  • 杨华磊, 胡慧娟, 李双双, 唐丽丽, 曹顺子
作者信息 +

Research on the Development Characteristics of DRG/DIP Payment Method Reform Policies in China——A Quantitative Analysis Based on 231 Policy Texts

Author information +
文章历史 +

摘要

政策是促进改革纵深发展的重要推动力,为探究DRG/DIP支付方式改革相关政策的发展特征,本文采用政策文献计量法、内容分析法和社会网络分析法,构建“发布数量—发布形式—发布主体—政策力度—作用对象—政策工具”六维分析框架,对我国DRG/DIP支付方式改革相关政策进行量化分析。结果发现:我国DRG/DIP支付方式改革相关政策的数量随时间呈现出“增加—减少”的趋势,反映了从试点探索到确定推广,再到优化调整的过程;发布形式层次较低,缺乏权威性;整体效力呈现出“上升—骤减”的趋势,平均效力较低,与初期国家鼓励地方广泛探索尝试的特点相符;作用对象多样化,以改革实施方案为主;政策工具使用综合性强但不均衡。基于上述分析,本文提出以下政策建议:为加强DRG/DIP支付方式改革,从顶层设计入手提升政策效力与执行力,优化作用对象结构以激发协同效应,调整并增加需求型政策工具的使用,进而促进多元主体间的合作与政策协同性的增强。

Abstract

Policies serve as a vital driving force in advancing reforms in depth. To explore the development characteristics of policies related to the reform of DRG/DIP payment methods, this paper adopts the methods of bibliometrics, content analysis, and social network analysis to construct a six-dimensional analytical framework of "number of publications, publication forms, publication authority, policy intensity, targets, and policy tools." Through this framework, a quantitative analysis of relevant policies concerning the reform of DRG/DIP payment methods in China is conducted. The findings reveal that the number of policies follows a trend of "increase-decrease" over time, which reflects the process from pilot, promotion, to optimization and adjustment. The publication forms are relatively low-level and lack authority. The overall effectiveness demonstrates a trend of "increase-sudden decrease," with a relatively low average effectiveness, which is consistent with the encouragement of extensive exploration at the local level in the initial stage. The targets are diverse, with a focus on reform implementation plans, and the use of policy tools is comprehensive but imbalanced. Based on the analysis above, it is proposed to enhance policy effectiveness and execution from top-level design, optimize the structure of the targets to stimulate synergies effect, adjust and increase the use of demand-oriented policy tools, thereby promoting cooperation among multiple stakeholders and strengthening policy synergy to strengthen the reform of DRG/DIP payment methods.

关键词

DRG / DIP / 政策体系 / 量化分析 / 内容分析

Key words

DRG / DIP / policy systems / quantitative analysis / content analysis

引用本文

导出引用
杨华磊, 胡慧娟, 李双双, 唐丽丽, 曹顺子. 我国DRG/DIP支付方式改革政策的发展特征研究——基于231份政策文本的量化分析[J]. 中国医疗保险. 2024, 0(9): 70-78 https://doi.org/10.19546/j.issn.1674-3830.2024.9.010
Research on the Development Characteristics of DRG/DIP Payment Method Reform Policies in China——A Quantitative Analysis Based on 231 Policy Texts[J]. China Health Insurance. 2024, 0(9): 70-78 https://doi.org/10.19546/j.issn.1674-3830.2024.9.010
中图分类号: F840.684    C913.7   

参考文献

[1] 姚奕,陈仪,石菊.医疗保险支付方式改革:实践与研究进展评述[J].中国卫生经济,2017,36(04):36-39.
[2] 李祥飞,张振,于佳卉,等.基于PMC指数模型的我国医保支付方式改革政策量化与评价分析[J].中国医疗管理科学,2023,13(01):33-39.
[3] 李宗伟,蔡兰芳,苑荣,等.浙江省基本医疗保险支付制度改革的政策演进模式研究[J].医学与社会,2023,36(01):105-110.
[4] 邵佳娴,孙志红,于云聪,等.基于胡德政策工具的试点地区DIP政策文本量化分析[J].中国医院管理,2024,44(03):21-26.
[5] 张雨孟,林坤河,陈知禾,等.基于政策工具的我国DIP支付方式文本量化分析[J].中国卫生事业管理,2023,40(12):903-910.
[6] 侯瑞琴,刘鸿齐,胡超扬,等.我国DRG医保支付方式改革政策文本量化评价研究[J].卫生软科学,2024,38(05):4-9.
[7] 王峻霞,丁令智,褚淑贞.政策工具视角下DRG付费改革政策文本量化分析[J].卫生经济研究,2023,40(06):50-53.
[8] 郑秉文,韦玮.中国医保支付体系改革25年:成就、问题与展望[J].社会保障评论,2024,8(03):75-89.
[9] 彭纪生,仲为国,孙文祥.政策测量、政策协同演变与经济绩效:基于创新政策的实证研究[J].管理世界,2008(09):25-36.
[10] 李浩,戴遥,陶红兵.我国DRG政策的文本量化分析——基于政策目标、政策工具和政策力度的三维框架[J].中国卫生政策研究,2021,14(12):16-25.
[11] 黄新平,黄萃,苏竣.基于政策工具的我国科技金融发展政策文本量化研究[J].情报杂志,2020,39(01):130-137.

基金

中央高校基本科研业务费项目“医疗保险市级统筹对城镇职工个体医疗费用的影响研究”(2722022BY017)

Accesses

Citation

Detail

段落导航
相关文章

/