主管:国家卫生健康委员会
主办:国家卫生计生委医院管理研究所
中国科学引文数据库(CSCD)来源期刊
中国科技论文统计源期刊 中国科技核心期刊
《中文核心期刊要目总览》入选期刊

Chinese Nursing Management ›› 2026, Vol. 26 ›› Issue (9): 1435-1440.doi: 10.3969/j.issn.1672-1756.2026.09.029

• Oversea Comments • Previous Articles    

Linkage between Japan's nursing care necessity evaluation and health insurance reimbursement: implications and reflections

LIU Guiying, QUAN Shuping, WU Yimeng, LI Jiuqun   

  1. Ward 2, Department of Cardiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong province, 518036, China
  • Online:2026-09-15 Published:2026-09-15
  • Contact: E-mail:lijiuqun@sina.com E-mail:E-mail:guiying_liu@126.com

Abstract: This paper introduces Japan's Diagnosis Procedure Combination system and its nursing "additional reimbursement" mechanism, elaborating on the nursing intensity evaluation method centered on the "nursing care necessity" and its closed-loop application. By comparing the differences between Chinese and Japanese models of nursing service pricing and medical insurance payment, and synthesizing domestic research progress, this paper explores the feasibility, challenges, and policy implications of localized implementation in China. It aims to provide a systematic reference for quantifying the value of nursing care and establishing a compensation pathway based on nursing intensity in China.

Key words: nursing fee; nursing intensity evaluation; nursing human resource; medical insurance payment; Japanese healthcare system; healthcare reform

CLC Number: R47;R197