Objective: The paper explores the current situation, problems and paths of TCM payment by specific diseases to provide a reference for TCM medical insurance policy. Methods: A literature search was conducted using the keywords of traditional Chinese medicine, payment by specific diseases, Diagnosis-Intervention Packet/DIP, Diagnosis Related Groups/DRG, and the literature irrelevant or weakly related to this study was eliminated. And then we analyzed the current research status, problems and suggestions of payment by specific diseases in TCM, and summarized the implementation path of DIP for TCM. Results: Previous studies explored the feasibility of payment by specific diseases and suggested that medical insurance settlement methods with TCM characteristics should be explored. At present, DRG payment for TCM is being piloted in many places in China, but there are many problems. In the future, we should carry out in-depth exploration on single disease payment for TCM, construct DRG and DIP payment schemes in line with the characteristics of TCM, and take multiple measures to achieve the same effect and price for the same disease in both Chinese and Western medicine. Conclusion: Payment by specific diseases in TCM can increase the motivation of TCM medical institutions to provide TCM services. It is necessary to reflect TCM characteristics in the medical insurance payment method and disease grouping method in the future and promote the reform of TCM medical insurance payment method.
Key words
payment by specific disease /
DIP /
DRG /
TCM /
single disease payment
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