PDCA在医院医保管理中的应用  

Discussion on the application of the pdca method in medical insurance management in a general hospital in guangzhou

作　　者：卜秀珠 方亮[1] 王桂芹 BU Xiuzhu;FANG Liang;WANG Guiqin(Guangzhou First People's Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院,广东广州510180

出　　处：《现代医院》2020年第3期397-400,共4页Modern Hospitals

摘　　要：目的评价PDCA在医院医保规范化管理中的作用与意义。方法应用PDCA循环法对医院医保工作进行精细化管理与质量控制。结果医保工作管理质量明显提升,医保费用得到良好控制,医务人员对医保政策的知晓率得到提高,参保人就医满意度提高,同时获得医保行政部门的高度认可。结论PDCA循环法在医保管理应用中有显著的积极意义,对质量的提升与费用的控制都带来良好效果。Objective To evaluate the role and significance of PDCA in the standardized management of hospital medical insurance.Methods The PDCA cycle method was used to carry out refined management and quality control of hospital medical insurance.Results The quality of medical insurance work management has been significantly improved,medical insurance costs have been well controlled,medical staff’s awareness of medical insurance policies has been improved,and insured persons have increased their satisfaction with seeking medical treatment,and have been highly recognized by the medical insurance administration.Conclusion The PDCA cycle method has significant positive significance in the application of medical insurance management,and it has brought good effects to the improvement of quality and the control of expenses.

关 键 词：医保管理 按病种分值付费 PDCA 

分 类 号：R197.323[医药卫生—卫生事业管理]