新形势下医院医疗保险精细化管理分析  

Analysis of the Refined Management of Hospital Medical Insurance under the New Situation

作　　者：李艳 LI Yan(Medical Insurance Office,Jiangsu Shengze Hospital,Nanjing Medical University,Suzhou,Jiangsu Province,215228 China)

机构地区：[1]南京医科大学附属江苏盛泽医院医保办,江苏苏州215228

出　　处：《中国卫生产业》2021年第15期39-42,共4页China Health Industry

摘　　要：为提高我国现代医院的综合管理水平,提高医保服务的质量与稳定性,必须引入精细化管理理念,最大限度地缩减医疗资源的日常管理成本,深入贯彻数字化、现代化管理模式。通过建立全过程精细化管理机制,提高监管效率,合理分配医疗资源,避免恶性医患矛盾的发生,促进医保体系的健康发展。该文主要分析了精细化管理模式的内涵与具体应用价值,并指出了新形势下医院建立医保精细化管理机制的必要性,总结了通过构建精细化管理模式提升医保服务质量的可行路径,以期为医院医疗保险精细化管理提供一定借鉴。In order to improve the comprehensive management level of modern hospitals in our country and improve the quality and stability of medical insurance services,it is necessary to introduce refined management concepts,minimize the daily management costs of medical resources,and thoroughly implement digital and modern management models.Through the establishment of a refined management mechanism for the whole process,the efficiency of supervision is improved,medical resources are allocated rationally,and the occurrence of malignant doctor-patient contradictions is avoided,and the healthy development of the medical insurance system is promoted.This article mainly analyzes the connotation and specific application value of the refined management model,and points out the necessity for hospitals to establish a refined medical insurance management mechanism under the new situation,and summarizes the feasible path to improve the quality of medical insurance services through the establishment of a refined management model,with a view to provide a certain reference for refined management of hospital medical insurance.

关 键 词：精细化管理模式 医疗保险服务 医疗改革 

分 类 号：R19[医药卫生—卫生事业管理]