关键词: 中医优势病种, 按病种分值付费, 效果评价

Abstract: Objective To discuss the correlation analysis of the hospitalization expenses of TCM dominant diseases under the DIP payment mode,and provide a reference for further promoting the reform of the payment mode of TCM dominant diseases in Guangzhou. Methods The nonparametric test was used to analyze the number of inpatients,the average hospitalization cost,and the proportion of TCM comprehensive treatment on the data of inpatient records before and after the implementation of the TCM dominant diseases policy,the sample sizes were 6 057 and 7 028 respectively．Results After the implementation of the TCM dominant diseases policy,there was a slight fluctuation in the number of inpatients from 6 057 to 7 208,the average hospitalization cost was decreased by 7.02%（P<0.001）,the proportion of TCM comprehensive treatment costs had an increase of 0.8%（P>0.05）,the average length of hospital stay was shorten by 0.63 days（P<0.001）,the self-expense rate of the patients with the TCM dominant diseases of in the group was lower than that of the patients without the group,the total case mix index value of the hospital decreased,but there was a surplus on the group of TCM dominant diseases settlement.Conclusions The policy is conducive to the tripartite win-win of medical insurance,patients and hospitals．However,the enrollment rate of TCM dominant diseases need to be improved,which is suggested to increase the support for TCM hospitals．The proportion of TCM comprehensive treatment has not increased significantly,so it is suggested to improve the dynamic adjustment mechanism of medical service price of TCM treatment items．The TCM dominant diseases are only limited to hospitalization,and it is recommended to achieve full coverage of diagnosis and treatment units．

Key words: dominant diseases of traditional chinese medicine, diagnosis-intervention packet, effect evaluation