目的了解住院分娩产妇按人头付费对降低剖宫产率的影响。方法通过分析国内剖宫产率居高不下的主要影响因素,对比国内外医保支付方式,对按人头付费医保方式进行探讨。结果按人头付费医保方式可有效降低剖宫产率和住院费用,促进医疗质量,降低新生儿死亡率。结论通过住院分娩医保按人头付费,降低非医学因素的剖宫产。医师始终遵循临床路径管理指南,避免了重复检查、可避免的药品使用和耗材的消耗,因而实现了优质服务和适度医疗的统一,不仅保证了参保人员享受基本医疗服务的权益,也保障了医疗质量和医院的合理利益,同时,使医疗机构逐步将工作的重点转向预防保健工作,通过加强孕期教育,降低剖宫产率,降低成本,增加业务收支结余,配合医疗体制改革,具有重要的社会效益和经济效益高。为了降低剖宫产率,必须改变现有的医保按病种付费的支付模式。 Objective To understand the impact of hospitalized childbirth paid by mothers to reduce the rate of cesarean section. Methods By analyzing the main influencing factors of the high cesarean section rate in China, comparing with the domestic and international medical insurance payment methods, this paper probes into the payment-based medical insurance. The result of paid-for-the-money medical insurance can effectively reduce the cesarean section rate and hospitalization costs, promote medical quality and reduce neonatal mortality. Conclusions Payment by hospitalization for childbirth based on personal care reduces non-medical caesarean section. Physicians always follow the guideline of clinical path management, avoiding double check, avoidable drug use and consumption of consumables, thus realizing the unification of quality service and appropriate medical treatment, not only guaranteeing the rights and interests of insured persons in basic medical services but also ensuring Medical quality and the rational interests of the hospital. At the same time, medical institutions should gradually shift the focus of their work to prevention and health care. It is important to strengthen education in pregnancy, reduce the rate of cesarean section, reduce costs and increase balance of business receipts and expenditures, and cooperate with the medical system reform The social and economic benefits. In order to reduce the rate of cesarean section, we must change the current mode of payment of medical insurance pay by disease.