中国医疗保险
中國醫療保險
중국의료보험
CHINA HEALTH INSURANCE
2014年
2期
46-47,49
,共3页
总额控制%医院管理%建议
總額控製%醫院管理%建議
총액공제%의원관리%건의
the total pre-paid%hospital management%suggestion
三项基本医保住院患者已占住院患者总人数的79%，占住院收入的80%，医院的生存和发展与医保的关联日益密切。为实现医保与医疗共同发展，滨州医学院烟台附属医院将医保考核标准纳入医院质控管理、实施临床路径与病种付费相结合，将降低药占比、耗材占比，增加诊疗成分占比作为加强医院医保管理的主线来抓，纳入科室绩效考核。但医保定额的确定要有利于激励医疗供方看好病、多看病，缓解看病难、看病贵。
三項基本醫保住院患者已佔住院患者總人數的79%，佔住院收入的80%，醫院的生存和髮展與醫保的關聯日益密切。為實現醫保與醫療共同髮展，濱州醫學院煙檯附屬醫院將醫保攷覈標準納入醫院質控管理、實施臨床路徑與病種付費相結閤，將降低藥佔比、耗材佔比，增加診療成分佔比作為加彊醫院醫保管理的主線來抓，納入科室績效攷覈。但醫保定額的確定要有利于激勵醫療供方看好病、多看病，緩解看病難、看病貴。
삼항기본의보주원환자이점주원환자총인수적79%，점주원수입적80%，의원적생존화발전여의보적관련일익밀절。위실현의보여의료공동발전，빈주의학원연태부속의원장의보고핵표준납입의원질공관리、실시림상로경여병충부비상결합，장강저약점비、모재점비，증가진료성분점비작위가강의원의보관리적주선래조，납입과실적효고핵。단의보정액적학정요유리우격려의료공방간호병、다간병，완해간병난、간병귀。
The patients with three kinds of basic medical insurances accounted for 79% of the total number of hospitalized patients, accounted for 80%of the source of hospital income. The survival and development of hospitals and medical insurance is increasingly closely related. For the development of medical insurance and medical services, the Medical Insurance Evaluation Standards are incorporated into the quality control of hospital management, and clinical pathway is combined with single disease payment. Reducing the proportion of drug and material expense, while increasing proportion of medical care expense were taken as the key points of hospital and health insurance management. The quota of medical insurance should help the department of medical service provide better services and alleviate the dififculty and cost in seeking medical services.
