混合支付体系下医院医保质量管理  

Medical insurance quality management in hospital under the circumstances of mixed medical insurance payment system

作　　者：彭玲[1] 王昌明[1] 范乐勇[1] 杨新艳[1] 

机构地区：[1]桂林医学院附属医院

出　　处：《中国医院》2015年第4期66-68,共3页Chinese Hospitals

基　　金：广西壮族自治区卫生厅科技研究计划课题"新医改背景下医院医保质量管理体系构建研究"(Z2014310)

摘　　要：医院内部运行机制与医保支付方式改革形势不适,既有体制机制因素,也有医院自身建设滞后因素。文章分析了混合支付体系下医院的行为特点,对医院医保质量管理的内涵、难点、实现路径进行了论述,结合我院建立医保质量管理体系的实践,对医院医保质量管理体系运行模式进行了案例分析。The discomfort between inner operation mechanism in hospital and medical insurance payment system reform, is not only related to the problems existing in health care system, but also largely derived from the delay of self-construction of hospital. In this paper, firstly, the negative behaviors of hospital under the circumstances of mixed medical insurance payment system are analyzed. Secondly, the connotations, difficulties and pathways on implementing medical insurance quality management in hospital is expounded. Thirdly, a case study of medical insurance quality management system in hospital is interpreted.

关 键 词：混合支付体系 医疗保险 医保质量管理 

分 类 号：R197.32[医药卫生—卫生事业管理]