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医疗机构实现新农合异地即时结报研究
引用本文:毛云鹏,冯昌琪,林晓东,于志华,邓韧,沈明辉,付鹏,王帅,郑子荣.医疗机构实现新农合异地即时结报研究[J].中国数字医学,2013(12):6-9.
作者姓名:毛云鹏  冯昌琪  林晓东  于志华  邓韧  沈明辉  付鹏  王帅  郑子荣
作者单位:[1]四川省卫生信息中心信息技术部,四川省成都市上汪家拐街39号610041 [2]四川省医学情报研究所四川省卫生信息中心,四川省成都市上汪家拐街39号610041
摘    要:新农合异地即时结报就是参合农民在新农合定点医疗机构住院治疗,出院时由定点医疗机构按规定初审并垫付应给农比的新农合补偿费用,再由定点医疗机构与统筹地区新农合经办机构定期结算的过程。目前新农合参合人员外地生病就诊住院后都是由病人全额支付住院费用,再回到户口所在地进行结算报账,一次异地就诊结算时间长,且手续烦多,既不方便参合人员,也给新农合管理机构增加了大量的工作量,解决参合人员异地就诊实时结算己成为急需解决的问题。四川省在实现新农合异地即时结报时,采用WebService技术为定点医疗机构医院信息系统提供一套业务流程接口,使定点医疗机构通过阪院信息系统实现异地住院即时结报。通过该系统将使参加新农合的农村居民得到更好的医疗卫生服务,帮助他们减轻医疗负担,减少患重大疾病的风险。

关 键 词:新农合  医疗机构  异地即时结报

Research on New Rural Cooperative Oifsite Real-time Compensation
Institution:MAO Yun-peng, FENG Chang-qi, LIN Xiao-dong, et al
Abstract:Now the NVMS offsite compensation is facing a series of problems. First of all, For a long time, the complex procedures of compensation, that is not only inconvenient for patients, but also increase a lot of work to the management agencies. Secondly, the NCMS paid all medical expenses and then applied for reimbursement with a hospital receipt and other necessary documents of proof: Moreover, lead to the emerge of compensation interruption, delayed, decrease in the degree of farmer benefits. The new rural cooperative offsite real-time compensation is a concentrated expression of policies to support and benefit co-farlners. The relevant policies stipulated that the patients of co-farmers paid the pocket payment for inpatient service at designated medical institutions and then received reimbursements from the NCMS funds in accordance with the regulations. In order to realize the new rural cooperative offsite real-time compensation, Sichuan province used the Web Service technology to Provides a set of interfaces for hospital information system to deal with offsite real-time compensation. The overall goal of the NCMS is to improve the access of rural residents to health services and above all help rural residents reduce the risks that accompany catastrophic illnesses.
Keywords:NCMS  medical institution  offsite real-time compensation
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