以临床路径为基础的单病种定价方法研究

目的探索在保证医疗服务质量、有效控制医疗费用的基础上，合理的单病种付费标准制定方法。方法采用回顾性调查和分层随机抽样的方法，将实际发生的病种平均费用、临床路径下病种费用与病种成本进行综合比较。结果临床路径通过降低住院日、规范诊疗行为，有效地控制了不合理的医疗费用。结论病种付费标准的制定应以临床路径为基础，以社会平均的项目成本计算病种成本，以此成本作为病种付费的制定标准更具有合理性、科学性。

The Study of Pricing Method Based on Clinical Pathway for Single Disease

Objective To explore an efficient scientific method of making rational payment standard for single disease, on the basis of ensuring medical service quality and controlling medical expenditure. Method The retrospective investigation and stratified random sampling method were employed in the study to compare the practical average disease charge, the disease charge under clinical pathway with the disease model cost respectively and analyze them synthetically to work out the rational pricing method for single disease. Result With the implementation of clinical pathway, the irrational health care expenditure was efficiently controlled by shortening inpatient time and standardizing diagnosis and treatment. Conclusion The payment standard of disease model should be made on the basis of clinical pathway and the cost of disease model should be calculated on the basis of average item cost, which is more rational and scientific to standardize the payment for single disease model.