医疗保险病案的质量控制重点与管理对策

Key points and management of quality control concerning medical insurance records

作者简要阐明了基本医疗保险模式下病案内涵质量的重要性,并结合医疗保险经办部门对病案审核的具体要求,提出5个方面的质控重点。通过全员质量教育,提高质量意识、法律意识,树立病案质量-效益观念。制订病案质量控制标准和完善质量监控、反馈与奖惩机制。重视医疗保险部门的监督与评价,加强沟通,促进病案质量进一步提高。

This article brieves the significance of the quality of medical records in the mode of basic medical insurance and argues that five aspects concerning quality control should be brought into focus on coordination with the auditing requirements on the medical records put forward by the medical insurance department. The faculty should be educated to become quality-conscious and legality-conscious and the awareness of medical records quality-profit should be imbedded into their minds. The quality control standards of medical records should be set up and the system of quality control, feedback, rewards and punishment should be improved. The monitoring and evaluation by the medical insurance department should be treasured and mutual communication should be enforced to further improve the quality of medical records.