职工基本医疗保险实施信息化监测管理的效果评价  

Effect Analysis of Information Survey Management of Staff's Basic Medical Insurance

作　　者：方志伟[1] 武桂英[2] 赵新平[2] 田国栋[3] 沈伟珍[1] 

机构地区：[1]上海市闸北区彭浦街道社区卫生服务中心,上海200435 [2]复旦大学公共卫生学院,上海200032 [3]上海市闸北区卫生科研与信息研究中心,上海200070

出　　处：《中国初级卫生保健》2010年第9期1-2,共2页Chinese Primary Health Care

基　　金：国家卫生部卫生统计信息中心立项资助(2008)

摘　　要：运用定性和定量研究方法,对信息系统在基本医疗保险中的监管作用进行分析。利用该系统可以合理设置科室医保控制标准,对医生的处方行为和医保运行情况采用实时监控,及时了解全院医保费用使用情况,保障本机构医保总量控制的规范运行。对照组只能事后对处方违规进行人工监控,费时费力。利用该系统可以从根本上对医保运行实施监管,使有限的医疗资源得到合理使用。The qualitative and quantitative research methods were applied to research the information system＇s effect on basic medical insurance. The reasonable medical insurance standard was set by using this system. This system can real-time monitor the prescription behavior,medical insurance＇s running situation and protect the standardized operation of medical insurance. The control group only monitor the irrational prescription by staff. This system can monitor the running of medical insurance and improve the rational use of limited medical resources.

关 键 词：基本医疗保险 监测管理 效果 

分 类 号：R197[医药卫生—卫生事业管理] R842.684[医药卫生—公共卫生与预防医学]