医院适应医保预付制改革的探索与思考

The Eexploration and Thinking of the Adaptation of Medical Insurance Prepaid System in Hospital

复旦大学附属华山医院在一年多的医保总额预付制改革试点中,医疗费用的不合理增长得到有效控制,费用结构日趋合理,减轻了医保基金的支付压力;医院以医保预付制为契机,不断加强内涵建设,提高自身管理水平,规范医疗行为,促使医生在有限的资源下,不断提高诊疗水平和服务满意度。

Since the reform of medical insurance prepaid system in Huashan Hospital affiliated to Fudan University over one year ago, the irrational increase of medical expenditures has been effectively controlled, the structure is becoming more reasonable, and the pressure to pay the health insurance fund has been reduced. Our hospital make the reform as an opportunity to continuously strengthen the building of the content, improve management level, standardize medical practices, and encourage doctors continuously to improve the level of diagnosis and treatment and service satisfaction with limited resources.