日间手术医保支付体系的国际比较研究及启示&#x02014;&#x02014;基于英国、美国、德国、新加坡的实践

万西子; 赵阳; 潘丝雨; 于淼

doi:10.19546/j.issn.1674-3830.2026.5.015

中国医疗保险 ›› 2026, Vol. 0 ›› Issue (5) : 120-128. DOI: 10.19546/j.issn.1674-3830.2026.5.015

国际（地区）比较

日间手术医保支付体系的国际比较研究及启示——基于英国、美国、德国、新加坡的实践

万西子¹, 赵阳², 潘丝雨³, 于淼⁴

作者信息 +

An International Comparative Study on Medical Insurance Payment Systems for Day Surgery and Its Implications——Based on the Practices of the UK, the US, Germany and Singapore

Author information +

文章历史 +

摘要

日间手术作为一种高效、经济的医疗服务模式,已在全球发达国家广泛应用并形成相对成熟的发展体系。我国日间手术虽逐步迈入规范化发展阶段,但医保支付体系在支付标准、支付规则、与临床实际成本关联度及质量评价体系等方面有待进一步完善。本研究基于国际视野,选取英国、美国、德国、新加坡四个日间手术发展成熟的国家作为案例,重点聚焦其日间手术医保支付体系的制度进行逻辑比较分析,系统剖析各国医保支付体系的顶层设计逻辑与运行机制,以期为完善我国日间手术医保支付体系提供关于制度框架搭建与规则优化的针对性理论参考与实践建议。

Abstract

As an efficient and cost-effective medical service model, day surgery has been widely adopted in developed countries, where it has evolved into a mature system. Although day surgery in China is gradually entering a phase of standardized development, its medical insurance payment system still needs further improvement in terms of payment standards, payment rules, the degree of correlation with actual clinical costs, and the quality evaluation system. From an international perspective, this study selects four developed countries with well-established day surgery systems—the United Kingdom, the United States, Germany, and Singapore—as case studies. It focuses on a comparative analysis of the institutional logic behind their day surgery medical insurance payment systems and systematically explores the top-level design and operational mechanisms in these countries, to provide targeted theoretical references and practical suggestions for building the institutional framework and optimizing the rules of China’s day surgery medical insurance payment system.

导出引用

万西子, 赵阳, 潘丝雨, 于淼. 日间手术医保支付体系的国际比较研究及启示——基于英国、美国、德国、新加坡的实践[J]. 中国医疗保险. 2026, 0(5): 120-128 https://doi.org/10.19546/j.issn.1674-3830.2026.5.015

An International Comparative Study on Medical Insurance Payment Systems for Day Surgery and Its Implications——Based on the Practices of the UK, the US, Germany and Singapore[J]. China Health Insurance. 2026, 0(5): 120-128 https://doi.org/10.19546/j.issn.1674-3830.2026.5.015

中图分类号： F840.684C913.7

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