在医院医保工作中采取精细化管理措施的效果分析  

Analysis of the Effects of Implementing Refined Management Measures in Hospital Medical Insurance Work

作　　者：郭秀会[1] 李海琦 Guo Xiuhui;Li Haiqi(Price Management Office,the Second Hospital of Shandong University,Jinan 250033,Shandong Province,China;Price Management Office,the Second Affiliated Hospital of Shandong First Medical University,Tai'an 271000,Shandong Province,China)

机构地区：[1]山东大学第二医院物价管理办公室,山东济南250033 [2]山东第一医科大学第二附属医院物价管理办公室,山东泰安271000

出　　处：《中外医药研究》2025年第4期163-165,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:分析在医院医保工作中采取精细化管理措施的效果。方法:选取2023年1—12月山东大学第二医院收治的医保患者120例开展研究,2023年1—6月收治的60例医保患者为参照组,开展常规医院医保管理,2023年7—12月收治的60例医保患者为探究组,开展精细化医院医保管理。比较两组管理方法下管理质量和管理满意度。结果:探究组报销效率、合规合法遵循、信息管理、服务质量、费用控制、投诉处理评分高于参照组(P<0.001)。探究组管理总满意度高于参照组(P=0.045)。结论:医院医保工作中采取精细化管理措施的效果显著,可提高管理质量和患者管理满意度。Objective:To analyze the effects of implementing refined management measures in hospital medical insurance work.Methods:A study was conducted on 120 medical insurance patients admitted to the Second Hospital of Shandong University from January to December 2023.Sixty patients treated from January to June 2023 received conventional hospital medical insurance management as the control group,while another sixty patients treated from July to December 2023 received refined hospital medical insurance management as the experimental group.The study compared the management quality and patient satisfaction between the two approaches.Results:The exploration group scored higher than the reference group in reimbursement efficiency,compliance with laws and regulations,information management,service quality,cost control,and complaint handling(P<0.001).The overall management satisfaction of the exploration group was higher than that of the reference group(P=0.045).Conclusion:The implementation of refined management measures in hospital medical insurance work has significant effects,improving management quality and patient satisfaction.

关 键 词：医保工作 精细化管理 管理质量 管理满意度 

分 类 号：R197.1[医药卫生—卫生事业管理]