浅析我院医疗保险费用欠费原因及对策

目的分析医疗保险管理部门现行的管理制度与结算方式下造成拖欠医疗机构医疗保险费用的原因,以寻求更有效的管理方法,缓解双方的矛盾。方法对2001-2008年以来的医疗保险费欠费原因进行回顾性分析,并对城镇职工医疗保险和离休干部医疗保险欠费数据进行分项分析。结果在医疗保险管理部门现行的管理制度与结算方式下,利用其强势地位拖欠医院医疗费用是不合理的,是造成双方矛盾的主因。结论希望医疗保险管理部门制定重大政策时做到公平、公正、公开,并积极加强与医院的沟通,努力推动和谐医保建设。

Analysis of Cause of Medical Arrear in Medical Insurance and the Countermeasure

Objective To analyze the reason of the medical arrear under the existing medical management system and seek more effective management way to alleviate the contradiction.Methods The reasons for arrears of medical insurance since the period of 2001-2008 were retrospectively analyzed,and the data of arrear of medical insurance for urban workers and retired cadres was analyzed respectively.Results Under the existing medical management mode,medical arrear caused by its strong position was unreasonable,which was the main cause of conflict on both sides.Conclusion Medical insurance administration should develop a major,fair,just and open medical insurance policy,and actively enhance the communication with hospital and promote the harmonious development of medical insurance.