【关键词】紧密型县域医共体；人头总额预付；DRG付费；整体性治理；医保支付方式 【中图分类号】 R197 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2024.0535

    【Abstract】BackgroundAll regions in China are actively promoting thereform of the prepaid payment method for thetotalamountofmedicalinsuranceinthecontextoftheintegratedmedicalcommunity.However，theintegrationofRG/DIP paymentandthetotalamountpaymentpolicywithintheintegratedmedicalcommunityisstillintheexploratorystage.Although therehave beenstudiesonthecost control efectandcostcontrolmechanismof thecomposite medical insurance payment method，thereisstillromforexpansionObjectiveToanalyethesynergisticmechanismandefectsofapitationprepayentandDRG payment inthecompactcounty-level medical consortium.MethodsIn July2O23，a field surveywas conducted in Yindu District.Theconveniencesampling methodwasused toselectkeyinformantswithin theintegrated medicalcommunityfor semi-structured interviews( n=28 ).The interview outline covered medical insurance payment reform policies and measures， incentive mechanisms，work perceptionsandoptimizationsuggestions，etc.Basedontheholisticgovernance theory，thethematic framework analysismethodwasusedtoanalyze theinterviewdata tobuildacoordination mechanismframeworkfortheprepaid paymentforthetotalnumberofpeopleandtheDRG paymentintheintegratedmedicalcommunityinYindu District.Meanwhile ......