病案首页应用于按病种分值付费的影响因素分析  

Analysis of the Influencing Factors of the Application of the First Page of Medical Record to Pay by Disease Score

作　　者：陈维雄[1] 夏锋 蔡锦华[1] 陈泽波[1] 欧凡[1] Chen Weixiong;Xia Feng;Cai Jinghua;Chen Zebo;Ou Fan(Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510000)

机构地区：[1]广东省人民医院广东省医学科学院

出　　处：《中国医疗保险》2020年第1期51-54,共4页China Health Insurance

摘　　要：总额控制下的按病种分值付费是医保付费机制的创新,而病案首页质量管理在按病种分值付费中起着关键性作用。实践中不少医院在政策实施初期忽略了病案首页的重要性,对医院实施按病种分值付费改革甚至医院利益产生不利影响。本文通过对广州某大型三甲医院2018年1-10月的病案数据进行分析,阐述病案首页在病种分值付费中的重要作用,并在此基础上提出合理建议。The payment of disease score under the control of total amount is an important means in the new medical reform in China.And the quality management of the fi rst page of medical record plays a key role in the payment of the disease score.In practice,many hospitals ignored the importance of the fi rst page of the medical record in the initial stage of policy implementation.This affects the hospital's disease score work and even the benefi ts.This paper analyzes the medical records of a large-scale hospital in Guangzhou from January to October 2018,and demonstrates the important role of improving the fi rst page of medical record in the payment of disease score.On this basis,we put forward several suggestions.

关 键 词：医疗保险 病种分值付费 病案首页 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]