按病种分值付费支付改革环境下对医院医保管理新模式的探索  

Exploration of a New Mode of Hospital Medical Insurance Management under the Reform Environment of Paying According to the Value of Disease

作　　者：仇元元 Qiu Yuanyuan(Department of Medical Insurance Management,Shaoguan Northern Guangdong Second People's Hospital,Shaoguan 512026,Guangdong Province,China)

机构地区：[1]韶关市粤北第二人民医院医保管理科,广东韶关512026

出　　处：《中外医药研究》2024年第18期153-155,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：在按病种分值付费(DIP)支付改革环境下,医院医保管理面临着新的挑战和机遇。为了适应这一改革,医院需要探索新的医保管理模式,以实现精细化、高效化的运营管理。该文章通过搜集相关文献,深入分析医院医保管理现状,对DIP支付改革下的医院医保管理新模式进行探索,提出精细化管理策略、医保基金预算管理、医疗服务价格管理、医保信息化建设等相关政策,以期激发医疗机构内部管理改革,提高医疗服务质量和效率。Under the condition of pay according to the value of disease(DIP)payment reform,hospital medical insurance management is facing new challenges and opportunities.In order to adapt to this reform,hospitals need to explore new medical insurance management mode to achieve fine and efficient operation management.By collecting relevant literature,this paper deeply analyzed the current situation of hospital medical insurance management,and explored the new mode of hospital medical insurance management under the DIP payment reform.The article proposed the refined management strategy,medical insurance fund budget management,medical service price management,medical insurance information construction and other related policies,in order to stimulate the internal management reform of medical institutions and improve the quality and efficiency of medical services.

关 键 词：按病种分值付费 医院 医保管理 

分 类 号：R197.32[医药卫生—卫生事业管理]