CAJ | 학술논문

为破解医疗保险门诊特殊疾病发病率高、就医分散、费用大等难题,济宁市通过设立特殊疾病管理中心、实行尿毒症透析定额管理和抗排异治疗方案专家评定等措施,取得了较好的效果.其中,透析费用整体下降12%,抗排异治疗费用由年人均10万元降至7万元.
위파해의료보험문진특수질병발병솔고、취의분산、비용대등난제,제저시통과설립특수질병관리중심、실행뇨독증투석정액관리화항배이치료방안전가평정등조시,취득료교호적효과.기중,투석비용정체하강12%,항배이치료비용유년인균10만원강지7만원.
At present, it has become the focus of medical insurance management, to strengthen the management and control of special disease outpatient medical expenses. For this, positive exploration has been done in Jining City. The management foundation has been consolidated by four measures, including establishing a management center,etc. In view of the particularity of the uremic dialysis, documents on dialysis patients managment have been issued, so as to strengthen the highlighted management. It resulted in a decreased by 12%of the overall cost per capita. According to the fact of a largely increased amount of patients in need of organ transplantation anti-rejection therapy and the suddenly rised medical costs, the city followed the principle of “active and prudent, careful arrangement, step-by-step implementation”. Expert evaluation was developed for anti-rejection therapy, which has reduced the anti-rejection treatment costs by an average of 100,000 RMB to 70,000 RMB.