基于MDT的CHS-DRG付费下的管理持续改进

国家医疗保障局于2019年正式启动CHS-DRG付费改革。武汉大学中南医院作为CHS-DRG付费试点医院之一，通过组建DRG管理MDT团队，围绕CHS-DRG付费核心环节，联合开展CHS-DRG付费下的临床路径管理、药品和耗材治理、成本核算与绩效考核、监管病案首页质量、鼓励开展医疗新技术等，优化管理方案。经实践，医院CMI、平均住院日等指标持续改善，医疗新技术开展数量明显增加，改革取得较好成效。但仍需从医保部门合理补偿方面不断完善CHS-DRG付费方案，并积极关注支付方式改革对医疗质量和医院发展的长期影响。

Management Continuous Improvement under CHS-DRG Payment Based on MDT

The National Healthcare Security Administration officially launched CHS-DRG payment reform in 2019. As one of the CHS-DRG payment pilot hospitals, Zhongnan Hospital of Wuhan University has established a DRG management MDT team, centered on the core link of DRG payment, jointly carried out clinical pathway management under DRG payment, drug and consumable management, cost accounting and performance assessment, and supervised the quality of the front page of medical records,encouraged the development of new medical technology, etc., to optimize the management scheme. Through practice, hospital CMI, average length of stay and other indicators continue to improve, the number of new medical technology has increased significantly, and the reform has achieved good results. However, it is still necessary to continuously improve the CHS-DRG payment scheme from the aspect of reasonable compensation of the medical insurance sector, and pay attention to the long-term impact of the reform of payment method on the quality of medical care and the development of hospitals.