宁夏基层医疗机构一般诊疗费调查分析

Investigation on the Basic Medical Expense in Primary Health CareInstitutions in Ningxia

宁夏对基层医疗机构一般诊疗费实行总额预付、超支自付、结余自留、收支平衡的基本原则。各地市的支付方式不同,主要有据实支付、总额预付包干等。自治区医保监控系统和现场调查发现的主要问题有:以家庭为单位的集中连号就诊、门诊处方和门诊日志记录不全、一人多卡就医等。今后的对策是加快支付制度改革,全区实行统一的支付制度;强化结算过程管控;加大监督、考核、奖惩力度;加强信息化建设,提高信息化监管水平和能力。

In Ningxia, the payment for basic medical expense in primary health care institutions take the basic principle of prepayment, out-of-pocket payment when it is over-expended, retaining the reserve fund when it balanced, and keeping income and cost balanced. The basic rnecial expense in each city was paied in a different way, and it was mainly paid according to the actual expenditure, or paid in advance at a total amount, etc. The main problems that were found by Ningxia medical insurance monitoring system and field investigation are： doctors were visited in a family unit, the outpatient prescription and outpatient service logs were recorded insufficiently, a medical card was used by many people etc. The ways to deal with these situation are to speed up the payment system reform to implement an integrated payment system in the future, intensify the management of the account settlement process; increase supervision, assessment, rewards and penalties; reinforce the construction of information technology to improve the capabilities of information administration.