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目的 结合技术难度与风险程度的价值定价理论及成本导向定价方法，计算预立医疗照护计划(advance care planning, ACP)医疗服务项目价格。方法 选取贵州省、广东省、四川省5家大型三甲医院的医护人员作为成本数据收集对象，并于2023年3月—2024年1月通过临床问卷、专家咨询和实地调研获取成本数据，根据“邹俐爱定价模型”进行初步定价。结果 共有15名专家完成了函询，2轮专家函询有效回收率均为100%。通过临床问卷调查，ACP项目的技术难度与风险程度评分分别为66分与52分；经专家函询，确定基本人力配置为1名医师与1名护士组合；实地调研测得单次干预平均耗时(113.50±18.67) min。基于上述参数，代入邹俐爱定价模型进行计算，得出标准劳动成本为116.09元，辅助成本为100.42元。结合地区与医院等级调整系数，初步拟定ACP医疗服务项目价格为216.52元/次。结论 本研究综合价值要素，兼顾机构补偿、物耗及人员技术价值，制定本土化ACP医疗服务项目价格，为医保基金战略性购买提供依据。
Abstract：Objective To calculate the price of medical service items for advance care planning(ACP) by integrating value-based pricing theory(considering technical difficulty and risk level) and cost-oriented pricing methods.Methods Medical staff from five large tertiary Class A hospitals in Guizhou, Guangdong and Sichuan provinces were enrolled as research subjects. Relevant cost data were collected via clinical questionnaires, expert consultations and field investigations from March 2023 to January 2024. Cost data were obtained through clinical questionnaires, expert consultation, and field research, and preliminary pricing was performed based on the "Zou Li'ai pricing model".Results A total of 15 experts completed the consultation, and the effective response rates for both rounds of expert consultation were 100%. Through clinical questionnaire surveys, the technical difficulty and risk level scores of the ACP project were found to be 66 points and 52 points, respectively. Expert consultation determined that the basic staffing configuration would consist of a combination of 1 physician and 1 nurse. Field research revealed that the average time consumed for a single intervention was(113.50±18.67) minutes. Based on the aforementioned parameters, when substituted into Zou Li'ai pricing model for calculation, the standard labor cost was determined to be 116.09 yuan, and the auxiliary cost was 100.42 yuan. Taking into account the adjustment coefficients for region and hospital grade, the preliminary proposed price for the ACP medical service project was set at 216.52 yuan per session. Conclusion This study synthesizes value-based elements, taking into account institutional compensation, material consumption, and the technical value of personnel, to establish a localized price for ACP medical service programs, providing a basis for strategic purchasing by healthcare insurance funds.
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基本信息:
DOI：10.16821/j.cnki.hsjx.2026.11.009
中图分类号:R197.1
引用信息:
[1]何春菊,黄渊,陈达,等.预立医疗照护计划医疗服务项目定价方法研究[J].护士进修杂志,2026,41(11):1182-1188.DOI:10.16821/j.cnki.hsjx.2026.11.009.
基金信息:
国家自然科学基金资助项目(编号：72274235)
2026-06-15
2026-06-15