| 以流程管理为中心加强住院医保费用管理 |
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| 引用本文： | 魏俊丽,孙树学,孙文英,赵冠宏. 以流程管理为中心加强住院医保费用管理[J]. 中国医院, 2011, 15(8): 53-55 |
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| 作者姓名： | 魏俊丽 孙树学 孙文英 赵冠宏 |
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| 作者单位： | 首都医科大学附属北京友谊医院,100050北京市西城区永安路95号 |
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| 摘 要： | 北京市医疗保险的新政策对医院加强住院医保费用管理提出了新要求。对此，本院以流程管理理论为中心，结合住院医保费用管理方式的前置性、费用控制的时效性、过程管理的协作性和与政策调整的同步性四个特点对运行流程进行分析。研究显示，本院在流程管理运行中发现主流程没有完全跟进政策变化，补充流程欠完善，与其他部门流程链对接不够顺畅等问题。通过优化主流程，规范补充流程，理顺管理部门沟通对接点，增加培训环节等措施对现有流程进行了优化、规范，以提高医保管理质量，适应新政策的要求。
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| 关 键 词： | 流程管理 医疗保险 住院费用 |
Strengthening medical insurance hospitalization cost management focusing on process management |
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| Affiliation: | WEI Junli,SUN Shuxue,SUN WenyingBeijing Friendship Hospital,Affiliated to Capital Medical University,No.95,Yong′an Road,Xicheng District,Beijing,100050,PRC |
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| Abstract: | The new policy of medical insurance in Beijing has put forward new demands to hospital cost management.According to process management theory,the running process which involves pre-positive management mode,timeliness of cost control,cooperation of process management,synchronization with the policy adjustment are analyzed.There are some problems in the running process: main flow is not fully follow the policy change,additional processes are less developed,processes dock with other sectors difficultly and so ... |
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| Keywords: | process management medical insurance hospitalization cost |
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