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医院视角下医保基金使用管理的难点与策略研究

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简要梳理国家医保局成立以来医保专项整治与日常监管政策措施,研究医保监管领域、监管方式、监管内容等变化,重点分析医保监管新变化对医院内部管理的影响,并基于华中科技大学同济医学院附属协和医院实践,介绍了医院从重点领域、重点科室和重点机制方面入手,积极应对上述监管的新变化,规范医保基金使用内部管理措施及其成效.
Research on Difficulties and Strategies for the Use and Management of Medical Insurance Funds from the Perspective of Hospital
It provides a concise overview of the special rectification and daily supervision policies and measures of medical insurance since the establishment of the National Healthcare Security Administration,studies changes in medical insurance supervision fields,supervision methods,and supervision contents,and focuses on analyzing the impact of new changes in medical insurance supervision on the internal management of hospitals.Based on the practice of Union Hospital of Tongji Medical College of Huazhong University of Science and Technology,it introduces the hospital from the key areas,key departments and key mechanisms to actively respond to the above new changes in supervision,standardize the use of medical insurance fund internal management measures and their effectiveness.

public hospitalsmedical insurance fundsregulation

丁宁、张义丹、夏家红、张明、许栋

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华中科技大学同济医学院附属协和医院 湖北 武汉 430022

公立医院 医保基金 监管

湖北省卫生健康委面上项目

WJ2023M038

2024

中国医院管理
中国医院管理杂志社

中国医院管理

CSTPCD北大核心
影响因子:2.15
ISSN:1001-5329
年,卷(期):2024.44(8)