摘要
目的:分析医院医保管控平台的智能化应用,为智慧医院建设和医保管理精细化提供决策参考。方法:以湖南某三甲医院为例,将医保管控平台的智慧化应用融入到医疗服务全流程中进行分析,并通过近三年的医保大数据分析说明该医院的实施成效。结果:医保管控平台可以加强该医院内部运营管理,提高医院医保精细化管理程度,规范医疗服务行为,减少医保违规拒付情况。结论:医院医保管控平台的应用,有利于控制医疗费用不合理增长,促进智能医院建设,改善患者就医体验。
Objective:To analyze the intelligent application of hospital medical insurance management platform,and provide decision-making reference for the construction of smart hospital and the refi nement of medical insurance management.Methods:Taking a class-A hospital in Hunan as an example,the intelligent application of hospital medical insurance management platform was integrated into the whole process of medical service for analysis,and the implementation eff ect of the hospital was illustrated through the analysis of medical insurance big data in recent three years.Results:The hospital medical insurance management platform can strengthen the internal operation and management of the hospital,improve the fi ne management level of medical insurance,standardize the medical service behavior,and reduce the situation of illegal payment refusal of medical insurance.Conclusion:The application of hospital medical insurance management platform is conducive to control the unreasonable growth of medical expenses,promote the construction of intelligent hospital and improve the medical experience of patients.
作者
黄茜
Huang Qian(Hunan Provincial People's Hospital,Changsha,410001)
出处
《中国医疗保险》
2020年第11期67-70,共4页
China Health Insurance
关键词
医院医保管控平台
智慧医院
信息化
hospital medical insurance management platform
smart hospital
informationize
