基于“互联网+”的优化服务流程在医保门诊特定病种管理中的应用  

Application of Optimized Service Process Based on"Internet Plus"in Management of Specific Diseases in Medical Insurance Outpatient Service

作　　者：刘玲[1] 徐健梅 LIU Ling;XU Jianmei(Foshan City the First People's Hospital,Foshan,Guangdong 528000)

机构地区：[1]佛山市第一人民医院,广东佛山528000

出　　处：《智慧健康》2024年第34期116-119,共4页Smart Healthcare

摘　　要：目的探究基于"互联网+"的优化服务流程在医保门诊特定病种管理中的应用价值。方法收集2021年3月—2024年2月在本院接受诊疗的属于门诊特定病种的患者300例,将2021年3月—2022年10月纳入的患者140例作为参照组;将2022年11月—2024年2月纳入的患者160例作为试验组。参照组实施传统医疗服务流程;试验组实施基于"互联网+"的优化服务流程。比较两组的医疗费用、药品费用;比较两组服务效率评分、医保审批时间;比较两组对医疗与医保服务的满意度。结果试验组患者的医疗费用及药品费用较参照组低(P<0.05)。试验组服务效率评分较参照组高,医保审批时间较参照组短(P<0.05)。试验组患者对医疗与医保服务的满意度(95.62%)较参照组的满意度(89.29%)高(P<0.05)。结论在医保门诊特定病种管理中应用基于"互联网+"的医疗与医保优化服务流程,可为患者减轻医疗费用负担,提升服务效率,缩减医保审批时间,提升患者对医疗与医保服务的满意度。Objective To explore application value of the optimized service process based on"Internet plus"in management of specific diseases in medical insurance outpatient.Methods The paper collected 300 patients with specific outpatient diseases in our hospital from March 2021 to February 2024,140 patients with specific outpatient diseases from March 2021 to October 2022 were included in the reference group;160 patients with specific outpatient diseases from November 2022 to February 2024 in the experimental group.The reference group was treated with traditional medical service processes,and the experimental group with optimized service process based on"Internet plus".Medical and pharmaceutical expenses,service efficiency scores,medical insurance approval time and satisfaction degree with medical and medical insurance services were compared between two groups.Results Medical and drug expenses of the experimental group were lower than the reference group(P<0.05).The service efficiency scores of the experimental group were higher than the reference group,medical insurance approval time was shorter than the reference group(P<0.05).Satisfaction degree of the experimental group with medical and medical insurance services(95.62%)was higher than the reference group(89.29%)(P<0.05).Conclusion Application of medical and medical insurance optimization service process based on"Internet plus"in management of specific diseases in medical insurance outpatient can reduce the burden of medical expenses,improve service efficiency,reduce medical insurance approval time and satisfaction degree of patients with medical and medical insurance services.

关 键 词：医保门诊 特定病种 互联网+ 优化服务流程 管理 

分 类 号：R47[医药卫生—护理学]