Comparison and Enlightenment of Trigger Evaluation Indexes and Rules for Dynamic Adjustment of Medical Service Price

China Health Insurance ›› 2023, Vol. 0 ›› Issue (3) : 64-71.

China Health Insurance ›› 2023, Vol. 0 ›› Issue (3) : 64-71. DOI: 10.19546/j.issn.1674-3830.2023.3.009
Observation & Discussion

Comparison and Enlightenment of Trigger Evaluation Indexes and Rules for Dynamic Adjustment of Medical Service Price

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Abstract

Objective: The paper summarizes policies for dynamic adjustment of medical service price at the national level, compares the implementation plans of dynamic price adjustment in different regions, and analyzes the common indexes of triggering evaluation and the rules of public hospitals participating in the price adjustment. Methods: By literature research and comparative analysis, the paper reviews the policy documents on dynamic adjustment of medical service prices at the national and local levels, and compares the trigger evaluation indicators and rules. Results: The trigger mechanism of the implementation plan of dynamic adjustment of medical service price in various provinces has gone through three stages of development, i.e. qualitative trigger, half-qualitative and half-quantitative trigger, and quantitative trigger. Most provinces have not yet set up quotation rules for public hospitals. Conclusions: For those provinces where the mechanism of medical service price dynamic adjustment is not yet complete and the dynamic adjustment of medical service price has not been substantially executed, quantitative trigger evaluation indexes can be set up according to the characteristics of medical service projects. Meanwhile, we should set complex medical service quotation requirements and produce government’s guiding price rules, calculate item cost reasonably and take the cost as the basis of public hospital quotation, consider the economic development situation and balance the local price level with the price level in surrounding areas.

Key words

medical service item / general type / complex type / trigger evaluation index / adjustment rule / deep participation

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Comparison and Enlightenment of Trigger Evaluation Indexes and Rules for Dynamic Adjustment of Medical Service Price[J]. China Health Insurance. 2023, 0(3): 64-71 https://doi.org/10.19546/j.issn.1674-3830.2023.3.009

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