医保患者肿瘤日间病房诊疗模式分析  

Analysis of Diagnosis and Treatment Mode of Ambulatory Ward for Cancer Patients Covered by Medical Insurance

作　　者：谢龙涛[1] 王殿武 李伟[3] 张文震 

机构地区：[1]济宁医学院附属医院医保与物价管理处,济宁272029 [2]济宁市医疗保障局,济宁272113 [3]济宁医学院附属医院,济宁272029

出　　处：《中国医疗保险》2023年第1期78-81,共4页China Health Insurance

摘　　要：目的:介绍肿瘤日间病房管理模式及实践成效,为完善肿瘤日间病房诊疗模式提供建议。方法:通过问卷调查、资料分析法分析山东省某三甲医院肿瘤日间病房结算数据,探究肿瘤日间病房的优缺点。结果:肿瘤日间病房结算模式减轻了患者经济负担,减少了医保基金支出,优化了医疗资源使用效率。结论:探索开展医保政策支持下的肿瘤日间病房管理模式实现了患者、医院、医保三方共赢,对助力公立医院高质量发展、提高医保基金使用效率有着重要意义。Objective: The paper introduces the management model and effect of the cancer day ward, and provides suggestions for improving the cancer day ward model. Methods: Through questionnaire survey and data analysis, the billing data of cancer day ward in a Grade-A hospital in Shandong Province were analyzed to explore the advantages and disadvantages of cancer day ward. Results: The day ward settlement model reduced the economic burden of patients and the expenditure of medical insurance funds, and optimized the efficiency of medical resources.Conclusions: The implementation of the cancer day ward management mode supported by medical insurance policies has achieved a win-win situation for patients, hospitals and medical insurance, which is of great significance for promoting the high-quality development of hospitals and improving the efficiency of medical insurance fund.

关 键 词：恶性肿瘤 日间病房 医保结算 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]