Résumé
A description of the intervention measures of the reform program for integrated care and payment in pilot areas,covering such diseases as chronic obstructive pulmonary disease and cerbral stroke.The reform aims at exploring impacts on both medical behaviors and medical costs.Authors of the paper hold that the practice of packaged ceiling payment for a single disease is a two-edged sword for clinical pathway management,and joint efforts by the government,medical insurers,medical workers and patients at large are required to regulate medical behaviors over time.They also see the total growth of medical costs as an objective rule,and the correct way out for optimal use of medical insurance funds is to focus on makeup of such costs.
Résumé
The paper presented a reform program jointly launched by China National Health Development Research Center(CNHDRC) and the UK National Institutes of Health and Care Excellence (NICE) for integrated care pathway and payment reform in China,and its theory basis and framework as well.Intervention measures of the program in Shanxi,Chongqing,Shandong and Henan proved the program theory design as reasonable and implementation outcomes as successful.These two measures,though proven,fall far short of a total solution to overcome roadblocks in the ongoing healthcare reform,and further reforms are expected in the future.