某肿瘤专科医院优化医保患者跨省异地就医与结算研究
Study on Optimizing Cross-Provincial Medical Treatment and Settlement for Medical Insurance Patients in a Specialized Oncology Hospital
柳俊杰 1孙维帅 1田滢琪 2郑金坡 1张琪 1郭思柔1
作者信息
- 1. 天津医科大学肿瘤医院/国家肿瘤临床医学研究中心
- 2. 广西医科大学
- 折叠
摘要
目的 探讨当前跨省异地就医结算过程中存在的具体问题,提出并实施针对性改进措施,以简化跨省异地就医结算流程,提升异地医保患者就医体验,促进医院精细化管理提升.方法 通过收集医院内部数据、患者反馈、医保部门报告等多渠道信息,全面梳理跨省异地就医费用结算过程中遇到的问题.结果 分析发现包括政策制度层面不完善、技术系统间互联互通障碍、患者教育缺失等是导致问题产生的关键因素.结论 通过优化措施,提升异地患者服务质量,吸引更多异地患者就医,使异地患者来院就诊时知悉医保手续、就诊流程,医疗费用清晰,报销便捷,提升异地就医患者满意度,推动卫生健康事业从"以治病为中心向以人民健康为中心"转变.
Abstract
Objective To study specific problems found in the current cross-provincial medical settlement process,and to propose and implement targeted improvement measures,so as to simplify the cross-provincial medical settlement process,improve the medical experience of patients with non-local medical insurance,and promote the refinement of hospital management.Methods Problems encountered in the settlement of cross-provincial medical expenses were comprehensively sorted out through the collection of multi-channel information,such as internal data from hospitals,feedback from patients,and reports from medical insurance departments.Results The analysis revealed that the key factors leading to the problems included the imperfect policy and system level,the interconnection barriers between technical systems,and the lack of patient education.Conclusion Through optimization measures,the quality of services for patients from other places will be improved,more patients from other places will be attracted to seek medical treatment,so that patients from other places will be aware of the medical insurance procedures and consultation process.The medical expenses will be clear and the reimbursement will be convenient.The satisfaction of patients who seek medical treatment from other places will be improved.All these efforts will promote the transformation of medical services from"treatment as the center to people's health as the center".
关键词
医疗保险/跨省结算/医保联网Key words
Medical insurance/Settlements of cross-provincial medical bills/Medical insurance networking system引用本文复制引用
出版年
2024
NETL
NSTL
万方数据