维权与增效的有效路径选择——关于构建医疗监理体系的思考  

Effective Path Selection of Rights Protection and Efficiency Improvement——Reflection on the Construction of Health Supervision System

作　　者：黄显官[1] 杨珍[1] 郑远秀 

机构地区：[1]泸州医学院 [2]泸州市人力资源和社会保障局

出　　处：《医学与法学》2013年第5期46-49,共4页Medicine and Jurisprudence

基　　金：四川省哲学社会科学研究"十二五"规划课题"社会医疗保险基金安全运行和长期平衡的政策研究"(项目编号:SC12W2001)的阶段性成果

摘　　要：医疗监理事务所应该是属于中介服务类企业,能够独立、公正、科学和守法地开展工作。医疗监理在工作中发挥出以下作用:接受医保基金管理机构的委托,单独或共同完成委托事项;接受患者的委托,实现就医前为患者提供就医方案、就医时参与就医方案的形成、记录和收集就医资料、审查诊治方案的落实程度、审查医疗费用是否合理、协调医患矛盾、代表患者参与诉讼、制订后期康复保健方案等目的。Medical supervision office should belong to the intermediary service companies, and should be able to work independently, impartially, scientifically and legally. Medical supervision should play the following roles： to complete the entrusted matters separately or jointly by the entrustment of medical insurance fund man- agement institutions; to achieve the following goals by the entrustment of patients： providing patients with medical treatment before treatment, participating in various work in the process of treatment which includes the formation and record of the treatment plan, the collection of medical information, reviewing the implementation of the diagnosis and treatment plan, reviewing the reasonableness of medical expenses, coordinating the doctor-patient contradiction, participating in the legal proceedings on behalf of patients, making late rehabilitation care plan, etc..

关 键 词：医疗监理 医保基金 维权 效益 

分 类 号：R197.2[医药卫生—卫生事业管理]