医院内控信息化建设及成效分析  

Analysis of the progress and effect in informatization of hospital internal management system

作　　者：朱佳英[1] 祝菁菁[1] 

机构地区：[1]浙江省人民医院,浙江省杭州市310014

出　　处：《中国医院》2015年第7期45-49,共5页Chinese Hospitals

摘　　要：目的:为规范临床诊疗行为,适应多样化的医保监管模式,我院于2013年8月实施依托于信息系统的精细化内控管理,从医疗服务行为的源头着手,对就诊前、就诊中、就诊后3个环节展开全方位的信息化监管。本文对我院对内控信息化建设进行详细阐述,并信息化前后医保费用拒付情况进行比较分析。方法:通过Wilcoxon符号秩和检验,对2013年2-7月和2014年2-7月医保拒付金额、月均违规单据数以及月均医保拒付率等几个指标进行比较。结果:各指标的P值均小于0.05,两年同期相关指标的差异具有统计学意义。结论:内控信息化建设有助于规范诊疗行为,有助于医院的持续健康发展。Objective： In order to regularize medical behaviors and to match diversified management patterns, a refined internal management system based on the information system was carried out in our hospital in August, 2013. This internal management system, which starts with a general view to medical advices, the origin of medical behaviors, has been conducted as an all-round management method for the supervision of the complete medical treatment progress, i.e. supervision conducted before treatment, during treatment and after treatments. This paper introduces the progress we have made in the construction of such internal management system in our hospital. We also compare the medical insurance injection rate before and after conducting such management system. Methods： We have conducted statistical analysis with appropriate methods, as well as compared the medical expenses rejected by medical insurance, the monthly average number of documents which violated medical insurance, and the monthly average rate of rejecting pay for medical expense. All the data are collected from February to July in 2013 and the same time period in 2014. Results： P values of all comparisons are less than 0.05, which means the differences appeared in the comparison are statistically significant. Conclusion： Informatization of the hospital internal management has regularized medical behaviors and helps hospital sustainable and healthy development.

关 键 词：医保内控 精细化管理 信息系统 

分 类 号：R197.324[医药卫生—卫生事业管理]