在DRG/DIP支付方式改革中,特例单议机制在确保改革的科学性、公平性,引导价值医疗等方面发挥着重要作用。特例单议机制体现了特殊情况特殊对待、具体问题具体分析这一实事求是的科学思想,是确保DRG/DIP支付方式改革顺利推进的必要措施。东营市的实践证明,用好特例单议机制,必须明确其原理,厘清其必要性,将用好特例单议机制作为实施DIP支付方式改革的一个组成部分。在实际操作中,务必重视全流程公开透明,从严从细把握评审标准,坚持以数据分析促进闭环管理,坚持以“保基本”这一医保基本原则把握引领方向,在DIP支付方式改革中不断完善和用好特例单议机制。

During the reform of DRG/DIP payment methods, the special case negotiation mechanism plays an important role in ensuring the scientific and fairness of the reform, and guiding value-based healthcare. The special case negotiation mechanism embodies the scientific idea of special treatment for special situations and specific analysis of specific problems based on facts, which is a necessary measure to ensure the smooth progress of DRG/DIP payment reform. The practice in Dongying City has proved that to make good use of the special case negotiation mechanism, its principles must be clarified, its necessity must be clarified, and the use of the special case negotiation mechanism should be regarded as a part of implementing DIP payment reform. In practice, it is necessary to attach great importance to the openness and transparency during the entire process, strictly follow the evaluation standards from a detailed perspective, promote closed-loop management with the use of data analysis, adhere to the essential principle of “ensuring basic medical insurance” as the direction, and continuously improve and make good use of the special case negotiation mechanism in the DIP payment reform.