目的: 分析《护理类医疗服务价格项目立项指南（试行）》在各省份的落地特征、价格水平及调整情况,为护理价格改革提供实证依据。方法: 收集31个省份护理类医疗服务价格政策文件,采用描述性统计、价格涨跌分析,评估项目设置、价格分布及典型项目价格变化。结果: 全国各省份均已完成指南落地对接,项目设置高度统一,仅上海、浙江缺失个别项目;免陪照护服务在13个省份进行了“一对一”“一对多”等本地化适配。价格分布显示,特级护理—儿童均价最高（196.3元/日）,基础护理项目（如口腔护理）均价约10元/次;多数项目变异系数介于20%~45%。典型项目价格调整方面,Ⅰ级护理平均涨幅最高（71.3%）,特级护理（37.8%）和新生儿护理（48.1%）次之,但省际调整幅度差异较大。结论: 指南整合逻辑合理,省级落地总体规范,但价格存在区域差异。建议强化省级执行统一性,完善价格监测机制,加强宣传培训,并协同推进薪酬等配套改革。

Objective: The paper analyzes the implementation characteristics, price levels, and adjustments of the Guidelines for Establishing Pricing Items for Nursing Medical Services (Trial) across provincial-level regions in China, to provide empirical evidence for nursing pricing reform. Methods: Policy documents on nursing medical service pricing were collected from 31 provincial-level regions. Descriptive statistics and price change analysis were used to evaluate item setting, price distribution, and price changes of typical nursing items. Results: All provincial-level regions have completed the alignment and implementation of the Guidelines, with highly consistent item setting. Only Shanghai City and Zhejiang Province lacked a few items. Accompaniment-free care services underwent localized adaptations such as “one-on-one” “one-to-many” in 13 provincial-level regions. Price distribution showed that special care for children had the highest average price (196.3 yuan/day), while basic nursing items (e.g., oral care) averaged about 10 yuan per session. The coefficient of variation for most items ranged between 20% and 45%. Regarding price adjustments for typical items, Grade I nursing exhibited the highest average increase (71.3%), followed by special care (37.8%) and neonatal care (48.1%), with significant inter-provincial variation in adjustment magnitude. Conclusion: The integration logic of the Guidelines is reasonable, and provincial implementation is generally standardized, yet regional price differences exist. It is recommended to strengthen uniformity in provincial execution, improve price monitoring mechanisms, enhance publicity and training, and coordinate supporting reforms such as compensation systems.