Objective: The construction of a medical service price system involves multiple stakeholders such as healthcare security administrations, medical institutions, and patients. The orderly promotion of medical service price reform is of great significance for deepening the reform of the medical system and promoting the high-quality development of China's healthcare security industry. Method: Based on the PDCA cycle theory, this article systematically analyzes the reform practice path of Yuxi City in Yunnan Province as a provincial-level pilot city. Result: Research has shown that Yuxi City has initially formed a closed-loop management mechanism through institutional design and construction in the Plan stage, policy implementation and resource investment in the Do stage, effectiveness monitoring and problem identification in the Check stage, and feedback optimization and continuous improvement in the Act stage. The reform has optimized the hospital's income structure, ensured stable benefits for insured persons, and ensured the sustainability of medical insurance fund expenditures. However, in the process of medical service price reform in Yuxi City, there are also problems such as relatively outdated information management of medical service prices, incomplete design of medical service price adjustment system, gap between medical service price adjustment and medical institution demand, and shortage of professional personnel. Conclusion: It is recommended to take corresponding measures in four aspects: accelerating the construction of a comprehensive management information platform for medical service prices, effectively organizing dynamic adjustments tracking and monitoring of medical service prices, attaching importance to cost accounting of medical service items, and accelerating the construction of professional teams, in order to systematically promote the high-quality development of healthcare security.
Key words
PDCA cycle /
medical service prices reform /
dynamic adjustment /
healthcare security /
policy optimization
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