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异地医保实时结算的支付模式研究
引用本文:杨佳泓,;何萍,;王霏,;王晔,;罗方方,;于广军.异地医保实时结算的支付模式研究[J].中国卫生资源,2014(4):261-261.
作者姓名:杨佳泓  ;何萍  ;王霏  ;王晔  ;罗方方  ;于广军
作者单位:[1]上海申康医院发展中心,上海200041; [2]万达信息股份有限公司,上海201112; [3]上海市儿童医院,上海200040
基金项目:上海市科学技术委员会国内合作计划课题基金资助项目“面向长三角地区的跨区域医疗协同服务关键技术攻关与应用示范”(11595810700);国家科学技术部国家科技支撑计划课题基金资助项目“面向长三角地区的跨区域医疗协同服务应用示范”(2011BAH15806)
摘    要:针对跨省异地就医实时结算的支付模式难以界定的现状,分析了处理跨省异地医保实时医保结算时必须解决的3项关键问题,提出了可供选择的解决方案,为实现跨省异地就医医保实时结算进行了有益的探索。课题的实施对于推动跨省卫生协同服务水平的提高具有重大意义。

关 键 词:异地就医  医保实时结算  药品目录  医用材料目录

A study on the real-time settlement payment pattern of health insurance
Institution:YANG Jia-hong, HE Ping, WANG Fei, WANG Ye, LUO Fang-fang, YU Guang-jun ( 1.Shanghai Hospital Development Center, Shanghai 200041, China; 2. Wonders Information Company Limited, Shanghai 201112, China; 3. Children's Hospital of Shanghai, Shanghai 200040, China )
Abstract:This paper analyzed the three key problems that must be solved,and put forward alternative solutions of real-time settlement of health insurance when patients sought medical services across provinces. It aimed at the current indefinable payment pattern of health insurance settled in real-time and conducted some sound exploration in realizing real-time settlement of health insurance across provinces. The implementation of this plan is of great significance to improve cooperated healthcare levels.
Keywords:hospitalization in other places  real-time settlement  drug formulary  medical materials directory
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