为了认真学习和贯彻执行“分级诊疗双向转诊”制度,作者对十余年来的“病种质量分析与评审”工作进行了全面系统的分析与总结,特别是疾病的医疗费用结构。提出了:依据医院的功能任务与技术特点,不断充实、完善和实施医疗保险管理制度(付费方式),在尝试“总额预付”制度的基础上,从实际出发,积极建立和推进“病种质量综合评审付费”制度。 In order to conscientiously study and implement the system of “two-way referral for grading medical treatment”, the author conducted a comprehensive and systematic analysis and summary of the work on quality analysis and evaluation of the “disease types” for more than ten years, especially the medical expenses of diseases structure. Put forward the following suggestions: Based on the functional tasks and technical characteristics of the hospital, we will continue to enrich, improve and implement the medical insurance management system (payment method) and, on the basis of trying the system of “total prepayment”, proceed from the reality and actively establish and promote the “ Comprehensive evaluation of the quality of disease pay ”system.