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“按病种付费”是医疗保障的一种新型的预付费方式,要求医疗机构把疾病的诊断结果作为付费标准,而对诊疗过程中所发生的任何项目的费用都不单独考虑。目前这一方式还没有被大规模应用于临床实践,仅在部分地区和个别医院进行试点。由于这一方式是对现有的“按项目收费”的颠覆,一经提出就引起强烈反响。拥护者认为,“按病种付费”可以抑制不合理的医疗消费,提高医疗效率,有效缓解“看病贵”、“看病难”问题;反对者则认为,“按病种付费”会导致医疗机构为营利而降低医疗成本,为控制费用而选择接收人群,使医疗质量有所下降,使重症患者就医无门,于解决“看病贵”、“看病难”问题无益。那么,究竟该不该实施“按病种付费”?为此,本刊记者邀请了业内专家、学者以及部分公众就此话题展开了辩论。
Pay By Category is a new, pre-paid form of Medicare that requires medical institutions to use the diagnosis of disease as a standard of pay, regardless of the costs of any project that occurs during the course of treatment. At present, this approach has not been applied in large-scale clinical practice, only in some areas and individual hospitals pilot. As this approach is subversive of the existing “fee per project”, it raises strong repercussions upon its submission. Advocates believe that “paying by disease” can restrain unreasonable medical consumption, improve medical efficiency, effectively alleviate the problem of “seeing a doctor hard” and “seeing a doctor hard.” Opponents argue that “according to the disease Payment ”will lead to medical institutions to reduce the cost of medical treatment for profit, in order to control costs and choose to receive the crowd, so that the quality of care declined, so that critically ill patients without medical treatment, to solve the“ expensive ”,“ difficult to see a doctor ”The problem is not good. So, what should not be implemented “pay by disease”? To this end, correspondents invited industry experts, scholars and some members of the public debated this topic.