广州市某三级医院职工生育保险的管理实践  

Management Practice of Maternity Insurance for Employees in a Tertiary Hospital in Guangzhou

作　　者：卜秀珠 刘敬[2] 伍敏琦[2] Bu Xiuzhu;Liu Jing;Wu Minqi(Nansha Hospital of Guangzhou First People's Hospital,Guangzhou,510180)

机构地区：[1]广州市第一人民医院南沙医院医保办,广州510180 [2]广州市第一人民医院南沙医院,广州510180

出　　处：《中国医疗保险》2021年第7期69-72,共4页China Health Insurance

摘　　要：本研究以广州市某三级医院职工生育保险管理为例,运用鱼骨图根因分析工具和大数据分析等方法,查找职工生育医疗费用超额的原因,并制定相应管理措施,以降低职工生育次均费用,减少医院生育医疗费用超额情况发生,减轻参保人费用负担。Taking the employees’maternity insurance management in a tertiary hospital in Guangzhou as an example,this study uses Fishbone Diagram Analysis Tool and Big Data Analysis methods to fi nd out the reasons for the excess expenses of it.Through the development of corresponding management measures,we can reduce the average cost of maternity insurance for employees,reduce the incidence of excess expenses of maternity insurance in hospital,and reduce the cost burden of the insured.

关 键 词：职工生育保险 费用超额 管理措施 效果评价 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]