新农合网络即时结报的实践与思考

Practice and Exploration of Instant Calculation and Reimbursement in New Rural Cooperation Medical System

通过建立健全组织机构、实现网络信息对接、抓好全员培训及宣传、优化结报程序、提高结报质量、加强检查督导等方法,持续改进网络即时结报质量。新农合网络即时结报在为参合农民提供方便医疗服务的同时,也为医院带来了良好的社会效益和经济效益。新农合网络即时结报在试运行过程中取得了较好成绩,但目前面临的问题是扩面"瓶颈"难以突破,主要原因是统筹层次低、网络平台多等。

The measures included establishment of a sound organization, network information conjunction, staff training and promotion, optimization of calculation and reimbursement process, improvement of the calculation and reimbursement quality, strengthening inspection and supervision, continuous quality improvement network instant summary report. The instant calculation and reimbursement in new rural cooperation medical system not only provided more convenient medical services tot the participat- ing farmers, but also brought good social and economic benefits for the hospital. Mature experience was obtained in the pilot oper- ation, but the currently problem was that it was hard to break the extended surface ＂ bottleneck＂, mainly due to the low level of co -ordination, diversity network platform.