医保“双通道”处方管理系统的应用探讨  

Discussion on the Application of the“Dual-Channel”Prescription Management System for Medical Insurance

作　　者：陈莹莹 饶予林 黄嘉绿 刘苏东 古晓东 CHEN Yingying;RAO Yulin;HUANG Jialü;LIU Sudong;GU Xiaodong(Meizhou People’s Hospital,Meizhou 514000,Guangdong,China)

机构地区：[1]梅州市人民医院,广东省梅州市514000

出　　处：《中国卫生信息管理杂志》2024年第5期710-715,共6页Chinese Journal of Health Informatics and Management

基　　金：国家自然科学基金项目“Lnc RNA MALAT1靶向miR-126-5p调控mTOR途径增强血管内皮细胞粘附作用的机制研究”(82000410);广东省医学科研基金项目“白介素17D调控单核-内皮细胞相互作用促进动脉粥样硬化进展的分子机制研究”(A2023324)。

摘　　要：目的 探讨医保“双通道”处方管理系统的构建与应用,推动“双通道”政策落地,提升国家谈判药品可及性。方法 在建立医保“双通道”管理制度的前提下,通过设计医保“双通道”处方管理系统、优化就诊取药流程等举措,分析某医院2023年医保“双通道”处方流转实施情况。结果 该医院2023年共计开出“双通道”处方4 710人次,其中审核通过处方4 636人次,审核时长中位数为20.6 min。2023年开出的“双通道”药品以抗肿瘤药品为主,占88.7%(4 179/4 710)。结论 医保“双通道”处方管理系统可为参保人员提供便捷的服务,降低管理成本,提高工作效率,保障后续基金安全,有一定的推广应用价值。Objective To promote the implementation of the“dual channel”policy and improve the accessibility of national negotiated drugs,this study explores the construction and application of the“dual channel”prescription management system for medical insurance.Methods Under the premise of establishing the“dual-channel”management system for medical insurance,design the dual-channel prescription management system for medical insurance and optimize the outpatient prescription and drug-pickup process,this study analyzes the implementation of the“dual-channel”prescription flow transfer for medical insurance in our hospital in 2023.Results In 2023,a total of 4,710“dual channel”prescriptions were issued,among which 4,636 were approved,and the median audit time was 20.6 minutes.Anti-tumor drugs were the main“double-channel”drugs prescribed in 2023,accounting for 88.7%(4179/4710).Conclusion The"dual channel"prescription management system can provide convenient services for insured personnel, reduce management costs, improve work efficiency, and ensure the safety of subsequent funds, which has certain promotion value.

关 键 词：电子处方 医保“双通道” 医保基金 

分 类 号：R-058[医药卫生] R197.3