整合型支付:内涵、作用和实现条件*

医疗服务纵向整合是分级诊疗的重要内容,然而现有的医保支付方式的支付对象多为单个医疗机构,对机构间协作的激励不足。文章以“支付方式促进医疗服务体系纵向整合”为出发点,提出了“整合型支付”的概念,即以促进医疗机构间纵向服务连续和功能整合为目标的医保支付方式,并对其作用路径进行了分析,从管理考核、利益分配、薪酬绩效、 服务设计、信息建设等几个方面提出了整合型支付的实现条件。

Integrated Payment: Connotation, Function and Realization Conditions

Chinese Health Economics2023,42(6):5-7,16 The vertical integration of health services is an important part of hierarchical diagnosis.However,existing health insurance payment methods are mostly paid to individual providers and provide insufficient incentives for inter-institutional collaboration.Based on the point of "payment that promotes the vertical integration of medical service system",it proposes the concept of "integrated payment",that is,the health insurance payment aims at promoting the vertical service continuity and functional integration among medical institutions.It analyzes its function path,and proposes the realization conditions of integrated payment from aspects of management assessment,benefit distribution,salary performance,service design and information construction.