吴庆艳, 刘丽莎, 龚敏希, 翟理祥. 省域层面中医优势病种疗效价值付费改革方案比较研究. 2025. biomedRxiv.202508.00011
省域层面中医优势病种疗效价值付费改革方案比较研究
通讯作者: 翟理祥, zhai3071@qq.com
DOI:10.12201/bmr.202508.00011
A Comparative Study on the Reform of Payment for Curative Value of Dominant diseases of traditional Chinese medicine at Provincial Level
Corresponding author: Zhai Li-xiang, zhai3071@qq.com
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摘要:摘要:目的:通过8省中医优势病种疗效价值付费方案的对比研究,发现已有方案的不足,提出完善的政策建议。方法:对各地方案中的核心内容,病种选择、疗效评价指标、付费环节的应用和保障机制等方面,进行对比分析。结果:已有方案碎片化问题明显,各项具体内容设定差别较大,反映对方案核心内容理解存在明显差异,对中医疗效价值认识不统一,付费标准与疗效评价结果未挂钩,尤其对中医技术劳务价值缺乏认可等问题。结论:可借由中医突出优势选择病种,借鉴西医价值医疗的评价框架,构建中医疗效价值评价体系,并基于健康结果的“同效”开展“同价”支付,分阶段设置绩效指标并设定付费标准,实现疾病全过程的管理,发挥中医疗效价值,促进中医传承创新发展。
Abstract: Abstract: Objective: Through the comparative analysis of the payment program for the Curative Value of Traditional Chinese Medicine dominant diseases in 8 provinces, we found the shortcomings of the existing program and put forward the perfect policy suggestions. Methods: Comparative analysis of the core content of the programs in various places, the selection of disease types, efficacy evaluation indexes, the application of the payment link and the protection mechanism. Results: The fragmentation of existing programs is a obvious problem,the specific content settings of each item are quite different, reflecting differences in the understanding of the core content of the program, the existence of inconsistent understanding of Chinese medicines Curative Value, the failure to link the payment standard to the results of the Curative Value evaluation, and the lack of recognition of the value of Chinese medicines technical labor, among other problems. Conclusion: We can select disease types basing on the prominent advantages of traditional Chinese medicine, learn from the evaluation framework of western medicine value-based medical care, construct the evaluation system of Chinese medicine Curative Value, and carry out “equal price” payment based on the “same effect” of health results, set performance indicators and payment standards in stages, realize the whole process management of disease, and enhance the Chinese Medicine’s Curative Value, and promote the development of Traditional Chinese Medicine inheritance and innovation.
Key words: Curative value; dominant diseases of Traditional Chinese Medicine; payment提交时间:2025-08-06
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