军队医院医保指标管控系统设计与实现

Management and Control Systems on Medical Insurance Indicators in Military Hospital: Design and Development

目的为管理部门有效控制费用及制定管理策略提供有力数据支撑,将医务人员从繁重医保政策执行和费用拒付压力中解放出来。方法通过数据挖掘、异构系统整合等技术手段,构建军队医院地方医保指标管控系统。结果通过系统运行,为管理部门提供科学合理的指标制定方法,有效提升医院各项医保指标的达标率,管理粒度细化到科室和个人,通过量化指标,使得从管理者到医护人员,每个人都明确指标任务,做到心中有数。结论全面实现医保指标与军队医院HIS的有效结合,免除了管理人员繁重的手工计算及统计等工作,提升军队医院医保管理水平。

Objectives To supply sufficient data for administrative departments to control the costs and ex-penses efficiently , and establish the correct management measures .At the same time , the medical staff can be re-leased from the pressure of complicated medical insurance policies .Methods Management and Control Systems on medical insurance indicators was established by data mining and heterogeneous system integration technology . Results The system provides a scientific and reasonable method for development of indicators .The information can definitively link to departments and individuals .Quantitative indicators made everyone understand and imple-ment policies better .Conclusion The effective combination of medical insurance indicators and HIS liberated the staff from heavy work and enhanced the level of medical insurance management in military hospital .