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医院医保智能监控系统建设路径及成效分析
Construction Path and Effect Analysis of Intelligent Monitoring System of Hospital Medical Insurance
【摘要】 医疗行业独有的专业性、疾病的复杂性以及医保监管方式的滞后性等因素均对医保基金监管带来挑战。以山东省潍坊市某三级公立医院建设全流程、多维度、立体化医保智能监控系统的实践为例,对医院2020年以来医保智能监控系统建设和运行进行回顾性分析,总结取得的成效,并就进一步完善医保智能监控系统提出建设性意见。
【Abstract】 The unique professionalism of the medical industry, the complexity of diseases, and the lag of medical insurance supervision and other factors bring challenges to the supervision of medical insurance funds.Taking the practice of a tertiary public hospital in Weifang City, Shandong Province in the construction of a fullprocess,multi-dimensional and three-dimensional medical insurance intelligent monitoring system as an example,it retrospectively analyzed the construction and operation of the hospital’s medical insurance intelligent monitoring system since 2020,summarized the achievements,and put forward constructive suggestions on further improving the medical insurance intelligent monitoring system.
【Key words】 intelligent monitoring system for medical insurance; hospital; medical insurance funds;
- 【文献出处】 中国医院管理 ,Chinese Hospital Management , 编辑部邮箱 ,2023年12期
- 【分类号】R197.32
- 【下载频次】19