CAJ | 학술논문

目的：为管理部门有效控制费用及制定管理策略提供有力数据支撑，将医务人员从繁重医保政策执行和费用拒付压力中解放出来。方法通过数据挖掘、异构系统整合等技术手段，构建军队医院地方医保指标管控系统。结果通过系统运行，为管理部门提供科学合理的指标制定方法，有效提升医院各项医保指标的达标率，管理粒度细化到科室和个人，通过量化指标，使得从管理者到医护人员，每个人都明确指标任务，做到心中有数。结论全面实现医保指标与军队医院HIS的有效结合，免除了管理人员繁重的手工计算及统计等工作，提升军队医院医保管理水平。
목적：위관리부문유효공제비용급제정관리책략제공유력수거지탱，장의무인원종번중의보정책집행화비용거부압력중해방출래。방법통과수거알굴、이구계통정합등기술수단，구건군대의원지방의보지표관공계통。결과통과계통운행，위관리부문제공과학합리적지표제정방법，유효제승의원각항의보지표적체표솔，관리립도세화도과실화개인，통과양화지표，사득종관리자도의호인원，매개인도명학지표임무，주도심중유수。결론전면실현의보지표여군대의원HIS적유효결합，면제료관리인원번중적수공계산급통계등공작，제승군대의원의보관리수평。
Objectives To supply sufficient data for administrative departments to control the costs and ex-penses efficiently , and establish the correct management measures .At the same time , the medical staff can be re-leased from the pressure of complicated medical insurance policies .Methods Management and Control Systems on medical insurance indicators was established by data mining and heterogeneous system integration technology . Results The system provides a scientific and reasonable method for development of indicators .The information can definitively link to departments and individuals .Quantitative indicators made everyone understand and imple-ment policies better .Conclusion The effective combination of medical insurance indicators and HIS liberated the staff from heavy work and enhanced the level of medical insurance management in military hospital .