CAJ | 학술논문

银川市2015年1月1日开始实行“总额控制下按病种分值结算”住院费用的结算办法。新的结算办法迫使医院必须加强内部自主管理，强化成本控制、落实临床路径、加强医院信息化建设、规范医院医疗信息上传。本研究主要对此结算办法实施的政策背景及对医院内部管理的要求以及医院应对的措施进行阐述和分析，为政府医保管理部门在制定政策具体措施过程中提供参考，也为医院内部及时调整管理模式和工作流程，以便更好地应对和执行政策提出了相应的对策。
은천시2015년1월1일개시실행“총액공제하안병충분치결산”주원비용적결산판법。신적결산판법박사의원필수가강내부자주관리，강화성본공제、락실림상로경、가강의원신식화건설、규범의원의료신식상전。본연구주요대차결산판법실시적정책배경급대의원내부관리적요구이급의원응대적조시진행천술화분석，위정부의보관리부문재제정정책구체조시과정중제공삼고，야위의원내부급시조정관리모식화공작류정，이편경호지응대화집행정책제출료상응적대책。
Yinchuan city began since January 1,201 5 to implement the“Disease scoring settlement under total budget”for hospitalization cost settlement.The new settlement method impels the hospitals to strengthen internal management,strengthen cost control,implement clinical pathway,strengthen the construction of hospital informationization,and standardize the hospital medical information upload.This paper covered the policy background and hospital internal management requirements,as well as hospital response measures,for reference of government healthcare authorities in the formulation of policy specific measures,and for the hospital’s medical insurance management department to adjust management mode and work flow,in order to better respond to and implement the policy.