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医疗保险费用按病种偿付方式是借鉴美国的DRGS(按疾病诊断交付)而建立的。它是根据某种疾病在临床治疗过程中合理消耗资源数量归集而形成的。但由于疾病的复杂性、诊治方法的多样性,给病种医疗保险费用标准的制定带来一定的困难。因此,这种付费方式在国内外研究和使用范围上仅局限于一定种类疾病和特殊人群。随着国内医疗保险业的发展,在诸多的医疗保险费用支付方式中,这种医疗保险费用支付方式,在强调疾病、治疗、个体差异、项目成本等方面有其他方式不可替代的优点。
Medicare costs are reimbursed on a DRC basis (DRG delivery). It is based on a disease in the clinical course of the rational consumption of resources formed by the accumulation. However, due to the complexity of the disease and the diversity of diagnosis and treatment methods, it is difficult to formulate the standard of medical insurance expenses. Therefore, this payment method is limited to certain types of diseases and special populations at home and abroad in the scope of its research and use. With the development of the domestic medical insurance industry, in many medical insurance cost payment methods, such medical insurance cost payment methods have other irreplaceable advantages in emphasizing disease, treatment, individual differences, project cost and the like.