垂直管理体制下的放与统——广州市医保经办管理地方特色分析

Allowing Flexibility And Control Placed under the Vertical Management System and Organization

广州市实行市、区两级经办机构一体化垂直管理体制;在165个街道(镇)设置医保服务网点,形成网格化经办服务方式;建立业务调研和科研课题攻关团队,提升解决实际问题的能力和创新能力;全面导入ISO9001质量管理体系,推进标准化管理,强化整体功能;建立"审、防、控"三位一体的内控机制。这些具有地方特色的做法,有效促进了经办服务水平和经办能力的持续提升,为医保事业的可持续发展提供可靠的人力资源保证。

Guangzhou takes vertical management system integrating city and district level medical insurance agencies. Medical insurance service outlets are set in 165 streets （towns） forming service network .By establishing business investigation and research project teams we upgrade capacities of solving actual problems and innovation. In 2012 we introduced ISO9001 quality management system to advance standardization management and strengthen overall features. We established internal control mechanism combining audit, prevention and control. These practices with local characteristics contribute to the continous improvements of service level and management ability effectively and, provide reliable human resources for the sustainable development of medical insurance.