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HomeArticlesVol 34,2024 No.10Detail

Research on the development and management of clinical pathways Ⅲ: thoughts on the work of clinical pathways under the DRG/DIP payment model of medical insurance payment

Published on Nov. 13, 2024Total Views: 1048 timesTotal Downloads: 362 timesDownloadMobile

Author: PENG Shuzhen 1 LOU Jia'ao 2 LIN Kewen 1 YI Ye 1 JIN Yinghui 3 FENG Jiajia 4 ZHANG Pan 4 LIN  Likai 4 ZENG Hongli 5

Affiliation: 1. School of Medicine, Wuhan University, Wuhan 430071, China 2. Department of Nursing, Zhongnan Hospital of Wuhan University, Wuhan 430071, China 3. Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China 4. Institute of Hospital Management, Wuhan University, Wuhan 430071, China 5. Medical Insurance Management Department, Zhongnan Hospital of Wuhan University, Wuhan 430071, China

Keywords: Payment by diagnosis-related group Payment by diagnosis-intervention packet Healthcare payment reform Clinical pathway Hospital management

DOI: 10.12173/j.issn.1004-5511.202404070

Reference: Peng SZ, Lou JA, Lin KW, Yi Y, Jin YH, Feng JJ, Zhang P, Lin LK, Zeng HL. Research on the development and management of clinical pathways Ⅲ: thoughts on the work of clinical pathways under the DRG/DIP payment model of medical insurance payment[J]. Yixue Xinzhi Zazhi, 2024, 34(10): 1161-1169. DOI: 10.12173/j.issn.1004-5511.202404070. [Article in Chinese]

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Abstract

China is actively promoting Diagnosis-Related Group (DRG)/Diagnosis-Intervention Packet (DIP) payment reform alongside the implementation of clinical pathways. While existing research has explored the impact of DRG/DIP reform on healthcare service behaviors and public health, there is limited investigation into the synergistic mechanisms between clinical pathways and healthcare payment reform. China currently faces challenges in implementing both DRG/DIP payment reform and clinical pathways. However, given that both aim to control medical costs and improve the quality of care, they possess a high degree of compatibility. This paper examined the content of healthcare payment reform and delve into how clinical pathways and payment reform can achieve synergistic effects. It further explored how clinical pathways and DRG/DIP can be deeply integrated to maximize their combined impact, providing valuable insights for the application and promotion of DRG/DIP payment and clinical pathways.

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