医保智能审核与监控平台在医院信息化建设中的应用研究  

Research on the Application of Intelligent Medical Insurance Audit and Monitoring Platform in Hospital Informatization Construction

作　　者：刘京[1] LIU Jing(Handan First Hospital,Handan Hebei 056002)

机构地区：[1]邯郸市第一医院,河北邯郸056002

出　　处：《中国科技纵横》2024年第22期51-53,共3页China Science & Technology Overview

摘　　要：本文通过分析现代医疗保险体系的现状,阐述智能审核系统通过提高医保基金使用效率和透明度、优化医疗资源配置、提升医疗服务质量以应对相关挑战的过程,以及智能审核和监控系统在实际医疗环境中的实施效果。此外,本文还对智能审核在促进临床实践教学及医保支付方式创新中的作用,以及DRG支付模式和区域点数法总额预算进行探讨。This article analyzes the challenges faced by the modern medical insurance system and reveals that intelligent audit systems can address these challenges by improving the efficiency and transparency of medical insurance fund utilization,optimizing medical resource allocation,and enhancing the quality of medical services.This mainly includes the construction of intelligent auditing and monitoring systems,emphasizing the integration and application of modern technologies such as big data,cloud computing,and artificial intelligence,as well as the implementation effects of these systems in actual medical environments.In addition,this article also explores the role of intelligent auditing in promoting clinical practice teaching and innovation in medical insurance payment methods,including DRG payment mode and regional point method total budget.

关 键 词：医保智能审核 监控平台 医院信息化建设 

分 类 号：TP311[自动化与计算机技术—计算机软件与理论]