谈医疗保险定点机构的管理

厦门市自１９９７ 年７ 月１ 日医改后参保人持医疗ＩＣ 卡自主选择就医的办法，取消过去公费、劳保的定点医疗。医疗机构通过统一认识，内外调整，强化服务，注意形象等，增强了竞争意识、经营意识、服务意识。另外针对存在的问题如成本核算意识淡漠，控制费用成效甚微，约束机制未形成，医疗浪费较突出，质量管理亟待加强等。笔者建议：加强监督管理，强化制度落实；完善补偿机制，把握“阀门”开关；完善“社区”服务，拓展机构网点；实行病种管理，优化结算办法

On the management of designated medical insurance institutions

Since July 1,1997, medical reforms in Xiamen have enabled policy holders to take their medical IC cards and seek medical services of their own choice, doing away with past practices of designated medical treatment for those enjoying free medical care and labor insurance. Medical institutions, on their part, have enhanced their sense of competition, management and service by means of seeking unity of thinking, adopting internal and external readjustment, optimizing services and improving their images. However, there are still some weaknesses, such as a dim awareness of cost accountng, lack of effectiveness in cost containment, failure to form a binding mechanism, serious medical waste, and weak quality management. To counter these problems, the writer suggests that supervision and management be strengthened and implementation of rules and regulations be reinforced; compensation mechanism be perfected and appropriate control be exerciesed; community services be improved and institutional networks be expanded; and diseases related management be adopted and methods of accounting be optimized.