新医改背景下医院医保管理的挑战及策略探讨  

Discuss on challenges and strategies of hospital medical insurance management under new medical reform

作　　者：姜子霞[1] 张斌[1] 邢艺凡[1] JIANG Zi-xia;ZHANG Bin;XING Yi-fan(Qilu Hospital of Shandong University,Shandong Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院,济南山东250012

出　　处：《卫生软科学》2022年第8期78-80,共3页Soft Science of Health

基　　金：山东省社会科学规划重大理论和现实问题协同创新研究专项-山东省突发卫生公共事件应急管理体系构建(20BCXJ02);山东省社会规划研究项目-公立医院补偿机制改革的效应研究——以山东省三甲公立医院调查为例(16CCXJ07)。

摘　　要：在深化医保改革的大背景下,医院医保管理工作中存在的问题和矛盾日渐突出。文章从管理模式、信息网络、政策宣传、监管考核和人才建设等方面,分析了医院医保管理工作面临的挑战,并进一步探讨可行的解决策略。在新医改形势下,建议要切实解决医保服务领域群众急、难、愁、盼的问题,营造和谐健康就医环境,促进我国医院医疗保险事业的高质量发展。Under the background of deepening medical insurance reform,the problems and contradictions in the management of hospital medical insurance have become increasingly prominent.This paper analyzes the challenges faced by hospital medical insurance management from the aspects of management mode,information network,policy publicity,supervision and assessment,and talent construction,and further discusses feasible solutions.Under new medical reform situation,we should effectively solve the urgent problems,difficulties,concerns and expectations in the field of medical insurance services,create a harmonious and healthy medical environment,and promote the high-quality development of hospital medical insurance business in China.

关 键 词：新医改 医保管理 医院 挑战 策略 

分 类 号：R197.32[医药卫生—卫生事业管理]