Research on the Key Relationships of Medical Insurance Payment Reform:Taking Shanghai as an Example
Xu Jiajie
Lü Dawei
Zhu Bifan
Abstract：The reform of medical insurance payment serves as a crucial mechanism for regulating healthcare service practices and guiding the allocation of medical resources.It plays an essential role in ensuring equitable access to high-quality medical services while enhancing the quality and efficiency of medical insurance funds.It analyzed the relationship between national specification and local adjustment,the relationship between global budget management and payment methods,the relationship between DRG/Diagnosis-Intervention Packet and multiple payments,and the relationship between process management and regular settlement in the process of promoting medical insurance payment reform in Shanghai.It also proposed policy suggestions for relationships that need to be further straightened out,to provide reference for the establishment of effective and efficient medical insurance payment mechanism.
Keywords：medical insurance payment system reformglobal budgetDRGDiagnosis-Intervention PacketShanghai
Publication Date：2025-07-05
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 30-33 )