In order to further promote the reform of medical service price and strengthen the macro management of medical service price, the author constructed a calculation method for price adjustment space of medical service. This study was centered on two parameters of the historical base and the growth coefficient, to calculate the total amountof price adjustment. The historical base used the total revenue of medical services in the region from the previous year, and the growth coefficient was measured by two methods, the comprehensive indicator method and the consumer price index (CPI) reference method.Taking Suzhou, a national pilot city, as an example, the historical base in 2022 was 18 754 million yuan. By using the comprehensive indicator method, the annual growth coefficient was calculated to be 2.38%, and adjustment space of medical service price was 446.35 million yuan; According to the CPI reference method, the growth coefficient of Suzhou was 2.10%, and adjustment space of medical service price was 393.83 million yuan.The two methods for calculating the total amount each have their own advantages and disadvantages, and need to be further optimized and improved by drawing on the practical experience of reform in each pilot city.

目的:分析我国省域间中医类医疗服务价格差异水平.方法:微观上,单个项目价格水平采用描述性统计分析方法;宏观上,省域总体价格水平引入绝对价格差异评分和相对价格差异评分.结果:84％的中医类项目价格在省域间变异系数小于0.7;75％的省份相对价格水平与省域价区差异1个等次以内.结论:中医类医疗服务价格在各个省份间的差异程度总体可控,但部分价格差异很大的项目、与价区严重不匹配的省份亟待动态调价.

Objective:To design a set of evaluation index system for the medical service price reform mechanism, so as to provide reference for the evaluation of deepening the medical service price reform mechanism.Methods:On the basis of searching literature of medical service prices reformfrom August 2021 to March 2023, policy logic analysis and expert consultation were used to construct evaluation indexes for the medical service price reform mechanism, set evaluation index thresholds, and assign scores to index thresholds in different grades.Results:The evaluationindex system of medical service price reform mechanism included 5 level-1 indexes, 12 level-2 indexes and 35 level-3 indexes. After scoring, the scores of 5 level-1 indexes were 12, 24, 35, 21, and 8, respectively.Based on the percentile scoring method, the evaluation criteria were categorized into five grades: premium, excellent, good, average and failure.Conclusions:This study constructed a set of evaluation index system for the mechanism of medical service price reform, which had strong scientific and operability. However, due to the fact that medical service price reform in the new era is still in its initial stage, the index system need to be further optimized drawing on the practical experience of reforms in pilot cities.

本研究基于复杂型医疗服务的特点,模拟市场机制设计,从医院竞争性报价的逻辑出发,探究复杂型医疗服务价格调整的新机制.从目标导向和形成方法上,对医院自主报价、政府审核报价、生成拟调价格、遴选调价项目等四个关键环节进行详细分析,为各地调整复杂型医疗服务的价格提供参考.

医疗服务价格动态调整的触发机制包括启动与约束条件、评估周期和触发规则三个要素,据此将我国医疗服务价格动态调整触发机制的发展历程分为定性触发、半定性半定量触发、定量触发三个阶段.文章总结了定性触发阶段的基本情况,梳理并比较了半定性半定量触发阶段各省触发机制的异同,提出了通用型项目和复杂型项目定量触发机制的操作方法.

协议期满后接续采购是国家组织药品集采的重要组成部分.本文基于国采接续采购中的广东联盟和长三角联盟,对省际联盟接续采购的规则和结果进行了多维度分析,总结经验并提出建议.