The Research Of The Publicity Related To Prospective Payment System Based On Diagnosis Related Group System

As a technical tool of medical and health cost control,the Prospective Payment System based on Diagnosis Related Group System(DRGs-PPS)has been widely introduced in the world.Academic exploration on DRGs was carried out in China as early as the early 1980s,but due to the limited coverage of the medical insurance system and the level of information technology,DRGs-PPS reform was not launched at that time.In 2019,the government identified 30 national DRGs-PPS pilot cities,and the ISSUE of DRGs-PPS reform has further become a hot topic.The existing literature lacks sufficient theoretical interpretation and empirical analysis on the publicity of China's DRGs-PPS reform,and relevant research is in urgent need of indepth study.This study takes "research on publicity of DRGs-PPS reform" as the research topic.The research questions include:(1)What is the connotation of publicity of DRGs-PPS reform?(2)What is the public status of China's DRGs-PPS reform?What are the factors that affect the realization of publicity?(3)What are the problems and challenges in realizing the publicity of DRGs-PPS reform in China?What are the underlying reasons?(4)What experience can China learn from the publicity of foreign DRGs-PPS reform?(5)What is the basic principle of public improvement in China's DRGs-PPS reform?What are the specific paths to enhance the level of publicity?Based on the principles,policies and operation mechanism of DRGs-PPS reform,this paper takes improving the development path of DRGs-PPS reform as the starting point,takes publicity as the theoretical analysis perspective,and takes openness of participation,clarity of rights and responsibilities,equality of cooperation and fairness of distribution as the analysis dimension.In-depth analysis of the development status,problems,causes and improvement paths of the publicity of China's DRGs-PPS reform.This study takes Y City in Shandong Province as an empirical study case,mainly collects research data through in-depth interviews,and uses qualitative research topic inductive analysis method to answer research questions.The main findings of this paper are as follows:(1)The publicity of DRGs payment reform emphasizes the publicity of subjects,rights and responsibilities,communication and interests.(2)The development of publicity of China's DRGs-PPS reform has experienced three stages:the embryonic form of "initial publicity",the diffusion of "formal publicity" and the emergence of "substantial publicity".Value selection,resource dependence,equal consultation and public interest are important conditions for generating publicity of DRGs-PPS reform.(3)The problems and challenges facing the realization of publicity of DRGs-PPS reform in China include the "inertia" of public participation,the ambiguous positioning of rights and responsibilities of publicity,the "core-edge" versus vertical relationship model,and the imbalance of interest distribution.The deep reasons for the loss and alienation of publicity of DRGs-PPS reform are:the bias of public value and concept,the complexity of stakeholder structure,the government's long-term position as the center of power,and the conflict between individual interests and public interests.(4)In the process of DRGs-PPS reform in foreign countries,the orderly participation of stakeholders,clear rights and responsibilities,in-depth cooperation and benefit sharing have improved the level of publicity to a certain extent and provided important experience for China:The instrumental rationality and value rationality need to be unified,the "promoting effect" of service-oriented government should be brought into play,the collaborative governance mechanism should be constructed and improved,and individual interests and public interests should be taken into account.(5)To improve the publicity of China's DRGs-PPS reform,it is necessary to standardize the relationship between democracy and rule of law,coordinate the relationship between rights and obligations,and balance the relationship between fairness and efficiency.To improve the publicity of China's DRGs-PPS reform,the government,market and social stakeholders need to make sufficient efforts in ensuring the openness of public participation,realizing the clarity of the positioning of rights and responsibilities,promoting the equality of public cooperation,and strengthening the fairness of interest distribution.The realization of the publicity of DRGs-PPS reform is a systematic project.From the perspective of publicity theory,this study summarizes four dimensions of publicity:openness of participation,clarity of rights and responsibilities,equality of cooperation and fairness of distribution;Based on relevant literature and empirical research results,this paper extracts the development status,influencing factors,problems and causes of the publicity of DRGs-PPS reform in China.On the basis of drawing lessons from foreign experience,this paper gives deep consideration to the basic principles and concrete paths of public improvement in China's DRGs-PPS reform.This study has certain theoretical significance and practical value for clarifying the roles and functions of multiple stakeholders,improving the interaction between stakeholders,and constructing the consensus framework of stakeholders.