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诊断相关分组下的报销:医疗补助计划的经验

Reimbursement under diagnosis-related groups: the Medicaid experience.

作者信息

Hellinger F J

出版信息

Health Care Financ Rev. 1986 Winter;8(2):35-44.

Abstract

The implementation of the Medicare prospective payment system has sparked the growth of similar Medicaid systems. Eight State Medicaid agencies now employ a system based on diagnosis-related groups (DRG's), and another four State Medicaid agencies are planning to implement such systems in the near future. The eight DRG-based systems in existence in 1986 are examined in this article. Preliminary evidence presented herein indicates that Medicaid DRG-based systems have experienced reduced rates of increase in expenditures for hospital services and that hospital admission rates have not increased under these systems.

摘要

医疗保险预期支付系统的实施引发了类似医疗补助系统的发展。目前有八个州的医疗补助机构采用了基于诊断相关组(DRG)的系统,另外四个州的医疗补助机构计划在不久的将来实施此类系统。本文对1986年已有的八个基于DRG的系统进行了研究。本文提供的初步证据表明,基于DRG的医疗补助系统降低了医院服务支出的增长速度,并且在这些系统下医院入院率并未上升。

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