异地医保患者就医直接结算流程的再造与实践  

Reengineering and Practice of Direct Settlement Process of Nonlocal Hospitalization Bills

作　　者：甄诚 魏俊丽[1] 万昊[1] 赵冠宏[1] ZHEN Cheng;WEI Jun-li;WAN Hao(Beijing Friendship Hospital,Capital Medical University,Beijing,100050,China)

机构地区：[1]首都医科大学附属北京友谊医院,北京100050

出　　处：《中国医院管理》2019年第1期56-58,共3页Chinese Hospital Management

摘　　要：2017年3月,北京市某三甲医院通过了北京市人社局对异地医保患者持卡住院费用直接结算工作的验收,开始落实新政策。为此,从改善患者就医体验、更好树立医院品牌的角度出发,在流程再造理论的指导与新政策背景下,分析原流程中的局限性,通过院内成立专项工作小组,梳理出流程改造的关键点,进而对异地医保患者就医直接结算流程进行了再造与实践,取得了一定成效。下一步将继续做好流程优化工作,积极探索融合远程信息平台在新流程中的作用,同时也建议外省各地区可以进一步细化政策宣传工作。In March,2017,a Grade A tertiary Hospital of Beijing has passed the acceptance procedure of direct settlement of nonlocal hospitalization bills for inpatients with medical insurance holding social security cards from Beijing Municipal Human Resources and Social Security Bureau and began to put it into practice.Guided by'Business Process Reengineering'theory and the newest policy,the hospital rebuilt the direct settlement process of nonlocal hospitalization bills after analyzing the disadvantages in order to increase the satisfaction of medical experience and establish a better brand.The hospital set up a working group,and sorted out the key points in the process and achieved certain results.Optimizing the process continuously and exploring the role of integration of telematics platforms in the new process are needed in the next step.It is also recommended that other provinces and regions can further refine the publicity work of new policy.

关 键 词：流程再造 异地就医 直接结算 医院管理 

分 类 号：R197.1[医药卫生—卫生事业管理]