A Study on Existing Issues and Optimization Strategies for Incentive Mechanism of Triditional Chinese Medicine DRG Payment in Zhejiang Province
Yuan Lina
Gao Jun
Abstract：Against the backdrop of national medical insurance payment reform,it focuses on the incentive mechanism of Traditional Chinese Medicine(TCM)DRG payment in Zhejiang Province.By sorting out policy texts,integrating operational data of the authors'hospital and medical insurance settlement information,it systematically analyzes the practical effects of Zhejiang's combined policies of"TCM DRG grouping+TCM treatment rate incentive+outcome-based payment".It finds that there are currently problems of insufficient incentives such as undervaluation of TCM DRG groups and overspending of integrated Chinese-Western medicine cases.In response to these problems,it proposes optimization suggestions such as constructing a"two-dimensional evaluation model"to identify undervalued DRG groups,establishing a classification and price comparison relationship between TCM and Western medicine DRG groups,and improving the outcome-oriented dynamic adjustment mechanism,aiming to provide reference for improving TCM-friendly medical insurance payment policies.
Keywords：DRGTraditional Chinese Medicinemedical insurance paymentincentive mechanismZhejiang
Publication Date：2026-03-05
Online Publishing Date：2026-03-18(First online date of this platform, not the publication date of the document)
Pages：4( 30-33 )