我院门诊国家医保结算系统的设计与应用  

Research and Application of Outpatient National Medical Insurance Settlement System in Our Hospital

作　　者：陈建福 CHEN Jianfu(Department of Information,No.909 Hospital of Joint Support Force of the Chinese People’s Liberation Army,Southeast Hospital Affiliated to Xiamen University,Zhangzhou Fujian 363000,China)

机构地区：[1]联勤保障部队第九○九医院/厦门大学附属东南医院信息科,福建漳州363000

出　　处：《中国医疗设备》2024年第1期92-96,108,共6页China Medical Devices

基　　金：南京军区重点课题(11Z023);漳州市科技项目(ZZ2019J17)。

摘　　要：目的 运用信息化手段,实现门诊国家医保结算,优化医保患者门诊流程,提高患者就医满意度。方法 前端使用SunnyUI框架开发Winform应用程序,后端采用Spring MVC技术基于Java实现MVC设计模式与医院信息系统全面集成,采用前后端分离的方法开发支持国家医保的门诊医保结算系统。结果 通过门诊国家医保结算系统的应用,患者等候时间由(181±3)s下降至(89±2)s,医保结算完成时间从(119±2)s降低至(59±1)s,差错率由(1.31%±0.02%)降低至0,且差异均有统计学意义(P<0.05)。患者满意度明显提高,就诊效率显著提升。结论 门诊医保结算系统的实施,实现了患者本地结算、省内异地结算、跨省异地结算,优化了整个医保结算流程,提高了患者满意度,提升了医院的服务水平。Objective To realize the national medical insurance settlement of outpatient service based on information technology,to optimize outpatient procedures for medical insurance patients and improve patient satisfaction with medical treatment.Methods The front-end used SunnyUI framework to develop Winform applications,and the back-end used Spring MVC technology to achieve the full integration of MVC design pattern and hospital information system based on Java.The front-end and back-end separation method was used to develop outpatient medical insurance settlement system supporting national medical insurance.Results Through the application of the outpatient national medical insurance settlement system,the waiting time of patients decreased from(181±3)s to(89±2)s,the completion time of medical insurance settlement decreased from(119±2)s to(59±1)s,and the error rate decreased from(1.31%±0.02%)to 0,and the differences were statistically significant(P<0.05).Patient satisfaction has significantly improved,and treatment efficiency has significantly improved.Conclusion The implementation of the outpatient medical insurance settlement system has achieved local patient settlement,intra provincial and inter provincial settlement.It optimizes the entire medical insurance settlement process,improves patient satisfaction,and improves the service level of the hospital.

关 键 词：医保结算 门诊医保 医保电子凭证 Spring MVC OAuth2.0 WINFORM 

分 类 号：R197.324[医药卫生—卫生事业管理]