中外学者对RBRVS研究角度差异及对我国卫生政策的启示

目的:通过对1979—2018年中外文期刊中有关RBRVS论文进行分析、比较,以期为我国进一步探索RBRVS提供参考。方法:采用CiteSpace对中外期刊刊载的有关RBRVS论文进行分析,并对相关结果进行比较。结果:RBRVS年度论文数量方面,国外期刊经历了1988—1997年约10年间的快速增长后,呈现逐步下降态势,国内则自2010年以来呈现爆发式增长态势;国内与国外学者对RBRVS的关注热点存在明显差异:前者偏重微观医院的绩效与薪酬管理,后者则偏重宏观医疗保险医师费的支付。讨论:一是对RBRVS社会医疗保险医师费的政策工具功能的关注有待强化,二是需要探究公立医院热衷RBRVS的表层与深层动因,三是要对微观主体先行引入RBRVS对宏观卫生政策目标的积极与消极影响进行分析。

The interesting difference of RBRVS between Chinese and oversea scholars and its implications to China's health policy

Objective:Through the analysis and comparison of researches conducted Chinese and oversea scholars on RBRVS and which were published in Chinese and international journals from 1979 to 2018, this paper aims at providing references and suggestions for further health-related researches on RBRVS in China from both theoretical and practical perspectives. Methods:CiteSpace was used to analyze RBRVS papers published in Chinese and international journals, and relevant results were compared respectively. Results:In terms of yearly RBRVS related research, international journals have experienced a gradual decline after the rapid growth from the late 1980s to the end of the 1990s, yet the interests of domestic scholars blossomed since 2010. Significant variations were detected from the focus of domestic and foreign scholars in the research on RBRVS, whereby domestic researches were found to have been majorly focusing on RBRVS application in performance and salary incentives management within health care sectors on the micro-level, and the international study interest emphasized more on RBRVS guiding payment from the health insurance side on the macro-level. Conclusions:First of all, full utilization and maximization of the function of policy tools for RBRVS health insurance payment system need to be strengthened. Secondly, it is necessary to conduct more research in order to explore the reason motivating the public hospitals to engage in the introduction of RBRVS. Last but not least, it is urgent to positively introduce RBRVS to the micro-subjects for the macroeconomic health policy objectives through analysis of existing negative effects.