欧冠投注

索引号 11330300MB1685697R/2019-00140
组配分类 政策解读 发布机构 欧冠投注
生成日期 2019-12-30 公开方式 主动公开
《温州市基本医疗保险住院费用总额预算和DRGs点数付费实施细则》政策解读

一、起草背景

DRGsFUFEISHIDANGQIANGUOJIGONGRENZUIXIANJINDEYIBAOZHIFUFANGSHI,ZAIDUOGEGUOJIAQUDECHENGGONGDEYINGYONGJINGYAN。GENJUGUOJIAHEWOSHENGYIBAOZHIFUFANGSHIGAIGEYAOQIU,JIEHEWOSHISHIJI,QUANMIANTUIXINGZHUYUANYILIAOOUGUANTOUZHUDRGsDIANSHUFUFEIJUYOUHENQIANGDEBIYAOXINGHEKEXINGXING。

欧冠投注(YI)GUOJIACHUTAIZHENGCEHEJISHUGUIFAN。《GUANYUJINYIBUSHENHUAJIBENYILIAOBAOXIANZHIFUFANGSHIGAIGEDEZHIDAOYIJIAN》(GUOBANFA〔2017〕55HAO)YAOQIU,2017NIANQI,QUANMIANTUIXINGYIANBINGZHONGFUFEIWEIZHUDEDUOYUANFUHESHIYIBAOZHIFUFANGSHI。2019NIAN10YUE,GUOJIAYILIAOBAOZHANGJUZHIDINGLE《JIBINGZHENDUANXIANGGUANFENZU(DRG)FUFEIJISHUGUIFANHEFENZUFANGAN》,WEIZHUYUANANDRGFUFEIGAIGETIGONGLETONGYIDEBIAOZHUN。

(ER)SHENGWEISHENGZHENGFUHESHENGYIBAOJUYOUYAOQIU。JINNIAN6YUE28RI,SHENGWEISHENGAIZUTAOLUNTONGGUOZHEJIANGSHENGXIANYUYIGONGTIJIBENYILIAOBAOXIANZHIFUFANGSHIGAIGEFANGAN,SHENGYIBAOHUITONGSHENGCAIZHENGDENGBUMENLIANHEYINFA《GUANYUTUIJINQUANSHENGXIANYUYIGONGTIJIBENYILIAOBAOXIANZHIFUFANGSHIGAIGEDEYIJIAN》(ZHEYIBAOLIANFA〔2019〕12HAO),11YUESHENGYIBAOJUDENGSANBUMENLIANHEYINFA《ZHEJIANGSHENGJIBENYILIAOBAOXIANZHUYUANFEIYONGDRGsDIANSHUFUFEIZANXINGBANFA》ZHEYIBAOLIANFA〔2019〕21HAO,YAOQIUGESHEQUSHIYILIAOBAOXIANXINGZHENGBUMENZAI12YUE15RIQIAN,JIEHEDANGDISHIJI,HUITONGCAIZHENG、WEISHENGJIANKANGBUMENZHIDINGSHISHIXIZE,QUEBAO2020NIAN1YUE1RIBANBUSHISHI。

欧冠投注(SAN)YIBAOJIJINGUANLIYOUXUYAO。YISHIYIBAOJIJINPINGHENGXUYAO。XINCHANGTAIBEIJINGXIA,JIJINSHOURUGAOSUZENGZHANGJICHUBUFUCUNZAI,SHOUBAOZHANGSHUIPINGWENBUTIGAO、YILIAOJISHUBUDUANFAZHAN、YILIAOJIGOUGUIMOCHIXUKUOZHANG、YIGONGTIOUGUANTOUZHUQUANMIANTUIJIN、LAOLINGHUAJINCHENGZHUJIANJIAKUAI、RENMINJIANKANGXUQIUBUDUANPANSHENGDENGYINSUYINGXIANG,JIJINZHICHUHAIJIANGBAOCHIJIAOGAOSUDUZENGZHANG,JIJINZHICHUZENGFUYUANGAOYUJIJINSHOURUZENGFU,JIJINSHOUZHIPINGHENGCHUXIANGUAIDIAN。ERSHIJINGXIHUAGUANLIXUYAO。YUANYOUZONGEYUSUANGUANLI、ANXIANGMUFUFEI、ANDANBINGZHONGFUFEIDENGGUANLIXINGSHI,XIANGDUIJIANDANCUFANG,GUOCHENGGUANLISHOUDUANQUEFA,YI、BAOMAODUNJIAODUO,POQIEXUYAOGAIJIN,SHIXIANGENGJINGXIHUADEGUANLI。

(SI)GONGZUOYOUJICHU。YISHISHENGNEIYOUJIAODUODISHIYIJINGYOUSHIJIANJINGYAN。WOSHENGJINHUA、QUZHOU、TAIZHOU、DEQINGDENGDIXIANGJITUIXINGLEDRGsDIANSHUFUFEIGAIGE,RUIANSHI2018NIANTUIXINGANBINGZHONGFENZHIFUFEIQUDELEJIAOHAODEKONGZHILEJIJINZHICHUZENGZHANGLV。ERSHIWENZHOUSHIYILIAOJIGOUYOUJIAOHAODEXINXIJICHU,ZI2016NIANKAIZHANZHEJIANGSHENGWEIJIANWEIYIJINGZAIQUANSHENGERJIYISHANGYIYUANSHISHILEDRGJIXIAOGUANLI,GEYIYUANDUIDRGYIJINGYOUJIAOSHENDELEJIE。

二、起草依据

欧冠投注1、《GUOWUYUANBANGONGTINGGUANYUJINYIBUSHENHUAJIBENYILIAOBAOXIANZHIFUFANGSHIGAIGEDEZHIDAOYIJIAN》(GUOBANFA〔2017〕55HAO)

2、《GUOJIAYILIAOBAOZHANGJUGUANYUYINFAYILIAOBAOZHANGBIAOZHUNHUAGONGZUOZHIDAOYIJIANDETONGZHI》(YIBAOFA〔2019〕39HAO)

欧冠投注3、GUOJIAYILIAOBAOZHANGJUBANGONGSHI《GUANYUYINFAJIBINGZHENDUANXIANGGUANFENZU(DRG)FUFEIGUOJIASHIDIANJISHUGUIFANHEFENZUFANGANDETONGZHI》(YIBAOBANFA〔2019〕36HAO)

4、ZHEJIANGSHENGYILIAOBAOZHANGJUDENG5BUMENYINFA《GUANYUTUIJINQUANSHENGXIANYUYIGONGTIJIBENYILIAOBAOXIANZHIFUFANGSHIGAIGEDEYIJIAN》(ZHEYIBAOLIANFA〔2019〕12HAO)

欧冠投注5、ZHEJIANGSHENGYILIAOBAOZHANGJUDENG3BUMENYINFA《ZHEJIANGSHENGJIBENYILIAOBAOXIANZHUYUANFEIYONGDRGsDIANSHUFUFEIZANXINGBANFA》ZHEYIBAOLIANFA〔2019〕21HAO

6、OUGUANTOUZHUDENGSIBUMENLIANHEYINFA《WENZHOUSHITUIXINGDUOYUANFUHEYIBAOZHIFUFANGSHIGAIGEGONGZUOFANGAN》WENYIBAO〔2019〕3HAO

三、主要内容

1、ZONGEYUSUANGUANLI。ZONGEYUSUANBAOKUOTONGCHOUQUCANBAORENYUANZAIBENDIHEYIDIZHUYUANDEYIBAOJIJINZHICHUJINE,ANZHAOTONGCHOUQUSHANGNIANDUYIBAOJIJINJUESUANZONGEHEYIBAOJIJINZHICHUZENGZHANGLVQUEDING,ZHICHUZENGZHANGLVZONGHEKAOLVXIAYINIANDUSHOUZHIYUSUAN、ZHONGDAZHENGCEDIAOZHENGHEYILIAOOUGUANTOUZHUSHULIANG、ZHILIANG、NENGLIDENGYINSU,YOUGETONGCHOUQUNIANDULIANXIHUIYISHANGDING。

BABENDI、YIDIZHUYUANFEIYONGQUANBUHANGAI,BIMIANYIYUANNIANDIYINYUSUANCHAOBIAO,BADANGDICANBAOBINGRENZHUANDAOTONGCHOUQUWAIJIUZHI。TONGGUOJIANLITANPANQUEDINGZHICHUZENGZHANGLVJIZHI,BAOZHENGZONGEYUSUANZHIBIAOQUEDINGGENGGONGKAI、GENGKEXUE、GENGGUIFAN。

欧冠投注2、JISHUBIAOZHUN。DRGs BIAOZHUNYOUGUOJIAHESHENGJIYIBAOBUMENBANBUBINGSHIXINGDONGTAIDIAOZHENG。QUANSHENGTONGYIZHIXINGGUOJIABANBUDEJIBINGFENLEI、SHOUSHUCAOZUO、ZHENLIAOXIANGMU、YAOPINFENLEI、YIYONGHAOCAIBIANMA、BINGANSHOUYEDENGBIAOZHUN。

TONGYIQUANSHENGDRGs JISHUBIAOZHUN,BIMIANZHIDUHEGUANLICHUXIANXINDESUIPIANHUA。

3、DIANSHUJISUAN。DRGs DIANSHUYOUOUGUANTOUZHUYIQUANSHIWEIDANWEIJINXINGJISUAN。GEDRGDEJIZHUNDIANSHU=GAIDRGZHUYUANJUNCIFEIYONG÷QUANBUDRGZHUYUANJUNCIFEIYONG×100。BINGCANKAOLEJINHUADENGXIANSHIXIANXINGDISHIDECAOZUOXIZE,JIEHEWOSHI120WANFENBINGANSHUJUDETONGJIXUEFENXI,DUIGAOBEILVBINGLI、DIBEILVBINGLIDENGJISUANFANGFAJINXINGLEMINGQUE。

欧冠投注FANGANJIEHESHENGWENJIAN,KAOLVLEYIYUANXINJISHUDEFAZHAN,YEBIMIANLEYIYUANKENENGHUICHUXIANDEFENJIEZHUYUAN、XIUGAIZHENDUANJIELUN、SHENGJIZHENDUANHECAOZUOBIANMADENGQINGKUANGDEFASHENG。

欧冠投注4、DIANZHIJISUAN。DRGs DIANZHIYOUTONGCHOUQUYIBAOBUMENYIQUANTONGCHOUQUWEIDANWEIJINXINGJISUAN。 DRGs DIANZHI=NIANDU DRGs FEIYONGJIESUANZONGE÷NIANDUZONGDIANSHU。TONGCHOUQUDINGDIANYILIAOJIGOUFASHENGDESUOYOUZHUYUANFEIYONGJUNNARU DRGs FUFEIGUANLI,HANYIDICANBAORENYUANZAIBENTONGCHOUQUZHUYUANDEZHIJIEJIESUANZONGFEIYONGHEZIFEIJIESUANBINGRENZHUYUANZONGFEIYONG。

欧冠投注TONGGUOZHIDUSHEJI,YIYUANSHOUZHIBENDI、YIDIZHUYUANBINGRENDEDAODEFEIYONGYIZHI,BIMIANYIYUANQUBIEDUIDAISHINEIHESHIWAICANBAOBINGREN。

5、JIESUANLIUCHENG。MINGQUELEBINGANSHANGCHUAN、ZHONGSHENQUEREN、FANKUIDIAOZHENG、BINGLIRUZUDESHIJIANHELIUCHENG。YIBAOJINGBANJIGOUZAIYILIAOJIGOUFANKUIDIAOZHENGHOU15RINEI,ZUOCHUBINGLIFENZUDEZHONGSHENQUEREN,QUERENJIEGUOBUZAIBIANDONG。

MINGQUELEYUEDUJIJINYUFU,YIBAOJINGBANJIGOUZAIYILIAOJIGOUMEIYUEDESUOYOUBINGLI(CHUTEBINGDANYI)ZHONGSHENQUERENHOU10RINEI,ANYUEDUJIESUANJIEGUODEYIDINGBILIYUFUJIYILIAOJIGOU,YUFUBILIQUEDINGWEI90%。

MINGQUELENIANDUJIESUANHENIANZHONGQINGSUAN。BAOKUONIANDUDRGsFEIYONGJIESUANZONGE、YIBAOJIJINNIANDUJUESUANZONGE、NIANDUJIJINFENDAN(LIUYONG)JINE、YILIAOJIGOUNIANDUDRGsZONGDIANSHU、NIANDUDRGsDIANZHIDENGJISUANFANGSHI。

6、JIANDUGUANLI。JIANLIKAOHEJIANGFADIANSHUGUANLIJIZHI。ZAIDUIGEYILIAOJIGOUJINXINGNIANDUQINGSUANSHI,JIANGKAOHEJIANGFADIANSHUJIRUGAIYILIAOJIGOUDENIANDUZONGDIANSHUZHONG。YINRUDISANFANGJIANGUANOUGUANTOUZHU,DUIBINGANJINXINGJIAOCHACHOUYANG,TIGAODUIYIBAODASHUJUDEWAJUEFENXINENGLI,QIESHITISHENGYIBAOZHIHUIJIANGUANSHUIPING。


WENZHOUOUGUANTOUZHU

欧冠投注2019NIAN12YUE25RI