某三甲医院职工生育保险费用管理实践  

Practice of Maternity Insurance Expense Management for Employees in a Hospital of Class A and Grade Three

作　　者：余楚红[1] 胡女元[1] 陈喆 YU Chu-hong;HU Nv-yuan;CHEN Zhe(Medical Insurance Department,Jiangmen Central Hospital,Jiangmen,Guangdong 529030,China)

机构地区：[1]江门市中心医院医保科,广东省江门市529030

出　　处：《现代医院管理》2020年第6期69-71,共3页Modern Hospital Management

摘　　要：以江门市某三甲医院职工生育保险管理为例,分析了该院在职工生育保险政策实施前后患者服务人次、人均费用、住院天数、顺产占比、剖宫产人均麻醉费用情况等指标变化,探讨该院加强职工生育保险费用管理的情况,包括加大政策宣传、提高自身诊疗技术降低剖宫产率、降低患者平均住院日、开展临床路径管理等措施,有效控制了职工生育保险费用的超支,提高了医院医保管理效果。By taking the maternity insurance management of workers in a hospital of Class A and Grade Three in Jiangmen City as an example,the changes of patient service person/time,per capita cost,length of stay,proportion of natural childbirth,per capita anesthesia cost of Caesarean section and other indexes before and after the implementation of maternity insurance policy were analyzed.Then this paper discusses the situation of strengthening the management of maternity insurance costs of employees in this hospital,including increasing policy publicity,improving self-diagnosis and treatment technology,reducing cesarean section rate,reducing the average length of stay of patients,and carrying out clinical route management,etc.,so as to effectively control the overexpenditure of maternity insurance costs of employees and improve the management effect of medical insurance of the hospital.

关 键 词：职工生育保险 医保管理 费用管理 

分 类 号：R197[医药卫生—卫生事业管理]