浅论住院患者“先诊疗后结算”制度的风险控制  

Risk management of “Diagnosing and treating first, paid later” for inpatients

作　　者：孙晓峰[1,2] 朱有为[3] 柏涌海[3] 陈羽中[4] 蔡剑飞[4] 郑兴东[5] 

机构地区：[1]解放军第401医院医务处,山东青岛266071 [2]第二军医大学训练部,上海200433 [3]第二军医大学长征医院预防保健科,上海200003 [4]第二军医大学长征医院医教部,上海200003 [5]第二军医大学长征医院院办,上海200003

出　　处：《医学争鸣》2014年第4期47-49,共3页Negative

摘　　要：本研究从"先诊疗后结算"的试点运行现状入手,在分析了推行该模式的意义在于倡导公平公益、改善患者就医体验并有助于医疗机构规范管理、提升医疗透明度的基础上,尝试从风险控制的角度提出相关措施,认为严格准入制度和就诊标准、优化患者支付方式、建立患者付费预警机制、强化与社区卫生服务和双向转诊体系的衔接、完善社会救助补偿政策等措施,在逐步扩大试点范围的基础上,推进"先诊疗后结算"政策的健康有序开展和运行。The study first presented the current status of pilot operation of ＂Diagnosing and treatming first, paid later＂, and then analyzed the significance of the implementation of the mode. The mode is helpful to promote fairness and perfect public welfare of health services, to improve the experience of the patient in receiving medical treatment, and to standardize the management of medical institutions and enhance health care openness. With the premier of these advantages, we tried, from the perspective of risk control, to propose some measures like establishing strict access system and treatment standards, optimizing patients＇ payment routine, bettering the early warning mechanism, strengthening the convergence with community health services and two-way referral system, and improving the social assistance and compensation policy. We aim to accelerate the healthy and orderly development of the mode on the basis of gradually expanding the scope of the pilot operation of the ＂Diagnosing and treatming first, paid later＂.

关 键 词：先诊疗 后付费 风险控制 

分 类 号：R1-9[医药卫生—公共卫生与预防医学]