捆绑支付是以患者为对象,整合从诊断到术后恢复的若干连续的治疗步骤,把总体治疗费用支付给一个或多个医疗服务提供者。目前,美国采取三种主要的捆绑支付模型,包括“证实式服务”“普罗米修斯式”和“服务改进式”支付。系列的研究表明,捆绑支付能在保持甚至提高医疗服务质量的基础上,降低医疗服务的成本。捆绑支付在按病种付费的基础上增加了总额预算控制,引入了费用预付支付率计算方法和潜在可避免的并发症津贴奖励,这些基于证据的费用控制和基于奖励的激励机制都值得我国借鉴。 Bundled payments are patient-based, consolidating several consecutive treatment steps from diagnosis to postoperative recovery, and pay the overall treatment costs to one or more health care providers. Currently, the United States adopts three major bundled payment models, including “Proof Services”, “Promethean” and “Service Improvement” payments. A series of studies have shown that bundled payment can reduce the cost of medical services while maintaining or even improving the quality of medical services. Bundled payment increased the total budget control based on the payment of disease types, introduced the method of calculating the cost of prepayment and the potentially avoidable complication allowance rewards. These evidence-based cost control and reward-based incentive mechanisms all deserve my country’s reference .