参保农民住院将享“打包付费” Ginseng protect farmers will enjoy in hospital“Pay package”

新农合付费改革启动 保障水平不降低 控制不合理费用增长 New farming pay reform and safeguard level can't reduce the start control unreasonable increased costs

　　本市将启动新农合付费改革，今后新农合参保人员的付费制度将向城镇居民看齐，采取以疾病诊断相关组为主的“打包付费制”。

The city will start new farming and pay for reform，New farm in the future and ginseng protect personnel to pay system will look to urban residents，Take to disease diagnosis mainly related groups“Packaging system of payment”。

　　昨日，市卫生局联合财政局、民政局发布《关于做好2012年新型农村合作医疗工作的通知》，要求开展总额预付、按病种付费、按人头付费、按床日付费等支付方式改革和实施临床路径等措施。据市卫生局介绍，新农合支付方式改革选择门诊、住院综合付费政策改革模式，即：以DRG管理为基础，对常见病、慢性病基本诊疗服务采用按人头支付基本服务费和按比例补偿药费及检验、检查费用相结合的方式；对短期住院采用DRG为主的方式付费；对长期住院的护理或康复服务采用总量控制，按床日付费方式。以实现医疗服务效率有提高、保障水平不降低、不合理费用增长得到控制、医务人员收入有所提高的目标。

yesterday，The municipal bureau of joint bureau of finance、Civil affairs bureau released《In 2012 the preparation for the new rural cooperative medical work notice》，The total amount of demand in advance、Press disease to pay、On a per head pay、According to the bed, such as pay payment reform and the clinical pathway and other measures。According to the municipal bureau introduced，New farming and payment reform choose outpatient service、Hospital comprehensive reform mode for policy，namely：To DRG management as the foundation，Contribute to common、Chronic basic medical services made according to the head pay for basic service charge and compensation expenses for medicine and inspection in proportion、The way of the combination of the examination expenses；For the short hospitalization the DRG primarily way pay；For long in hospital care or rehabilitation service the total amount control，According to the bed, payment method。In order to realize the medical service efficiency is improved、Don't lower security level、Not reasonable cost growth under control、Medical personnel income increase goals。

　　市卫生局表示，新的保障政策中原则上提出全市统一筹资标准、统一政府补助标准、统一个人筹资。其中个人出资的增加一方面缩小了与城镇居民基本医疗保险个人出资部分的差别，另一方面也增加了参合人群对自身健康所承担的责任。同时，本市对门诊、住院的起付线、封顶线提出了统一指导标准。在充分考虑农民就医需求特点的基础上与目前城镇居民基本医疗保险补偿方案保持基本一致。

City health bureau said，New security policies put forward in the unified standard in principle financing、Unity government subsidies standards、Unified individual financing。Among them the increase of capital contribution on one hand out for urban resident basic medical insurance capital contribution, the difference between the part，On the other hand also increases the ginseng adds up to the crowd in their own health responsibilities。At the same time，Of outpatient service of this city、The fu biao since the line in the hospital、Top line puts forward the unified direction standards。In full consideration of the farmers based on the characteristics of the medical treatment demand with the urban resident basic medical insurance compensation plan to keep basic agreement。

名词解释 Nouns explain

　　DRG支付方式：即按诊断相关分类付费或按病种付费的方式，是一种打包付费制度，主要是根据患者年龄、疾病诊断、合并症并发症、治疗方式、病症严重程度以及疗效等多种因素，将诊断相近、治疗手段相近、医疗费用相近的住院患者，分入若干病组予以定额付费的医保结算方式。目前，美国、德国、澳大利亚等30多个国家和地区采用这种付费方式。

DRG payment：That is according to relevant classification diagnosis or to pay for press disease to pay way，Is a kind of packing pay system，Main is according to patients with age、Disease diagnosis、Complications complications、treatment、Disease severity and curative effect and so on many kinds of factors，Similar will be diagnosed、Similar treatment、Medical expenses of close hospitalized patients，Some of the points to pay for the disease quota medical insurance settlement。At present，The United States、Germany、Australia and so on more than 30 countries and regions adopt this payment。

　　跟DRG按病种付费相对应的是按“按项目付费”方式。“按项目付费”的最可能的弊端是引发医生开“大药方”，医院提供过度医疗服务。(记者 徐晶晶)

With DRG press disease to pay the corresponding is to press“According to the program paid”way。“According to the program paid”The disadvantages of the most likely to be a doctor away“Big prescription”，The hospital provides excessive medical services。(Reporter XuJingJing)