医保政策指导下医用耗材的使用管控探讨  

Discussion on the Control of Medical Consumables Use Under Medical Insurance Guidance

作　　者：尹军 刘相花 颜乐先 邓玲 陈世耕 陈茂玲 余涛毅 YIN Jun;LIU Xianghua;YAN Lexian;DENG Ling;CHEN Shigeng;CHEN Maoling;YU Taoyi(Department of Medical Engineering,Daping Hospital,Army Medical University,Chongqing 400042,China;Medical Insurance Management Office,Daping Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院医学工程科,重庆400042 [2]陆军军医大学大坪医院医疗保险管理办公室,重庆400042

出　　处：《中国医疗设备》2019年第1期142-145,共4页China Medical Devices

摘　　要：目的探讨医保政策下医用耗材使用管控的方法策略。方法分析医用耗材使用现状、管理特点,梳理医保政策和国家医疗改革相关政策、当前新医改的改革重点、方向,尤其是医保的付费制度改革。结果当前医用耗材收入在医疗总收入中占比较高,而医用耗材的成本支出高于医用耗材的收入;新医改医保政策下,结合医保付费制度改革和三联动改革政策,发挥医工部门的专业特长,进行精细化和信息化管理是做好医用耗材使用控费和使用管理的关键和重点内容。Objective To discuss the method and the management which are used in medical consumables under the medical insurance policy.Methods The current status and management characteristics of medical consumables using was analyzed.The medical insurance policies and related national health care reform policies were sorted out.The key point and direction of current reforms in new healthcare reforms,especially the reform of the payment system for medical insurance were described.Results The current income of medical consumable accounted for a relatively high proportion of total medical income,while the cost of medical consumable exceeded to that of medical consumables.Under the new medical insurance reform policy,combining with the reform of the medical insurance payment system and the triple linkage reform policy,the professional expertise of the medical industry department,the refinement and information management are the key and important contents for the cost control and use management of the medical consumables.

关 键 词：医用耗材 医疗保险 付费制度 耗占比 次均费用 

分 类 号：R197.32[医药卫生—卫生事业管理]