医保总额控制下门诊规定病种管理实践  

Practices of Outpatients' Formulary Disease Management under Total Medical Insurance Expenses Control

作　　者：杨莉华[1] 何多多[1] 

机构地区：[1]济南军区总医院医务部,济南250031

出　　处：《解放军医院管理杂志》2015年第11期1060-1061,共2页Hospital Administration Journal of Chinese People's Liberation Army

摘　　要：医疗保险总额控制付费制度的改革给医院管理带来冲击和挑战。某医院为适应医保门诊规定病种管理的新形势、新情况,通过加强政策培训、规范医疗行为、完善信息平台、引导合理就医、健全规章制度等措施,建立门诊规定病种管理的长效机制,在满足就诊需求、确保诊疗效果、控制医疗费用等方面取得成效。Total expenses control in the medical insurance payment system leads impacts and challenges to hospital management. In order to adapt to the new tendency and the new situation, our hospital adopted several measures in the management and service of outpatients＇ formulary disease such as enhancing policy training, stand- ardizing medical activities, improving and perfecting the information platform, conducting suitable medical service, and strengthening the regulations. Through these measures, the long - term mechanism of management and service of outpatients＇ formulary disease was preliminary built. Significant results were achieved in satisfying medical needs, insuring treatment effect, controlling medical expenses and so forth.

关 键 词：总额控制 门诊规定病种 管理实践 

分 类 号：R197.32[医药卫生—卫生事业管理]