医保推行电子处方结算控费的内在要求与实现

The internal requirement and realization of the implementation of electronic prescription settlement control cost in medical insurance

针对电子处方在医保结算领域的应用,分析了当前随着医保制度整合的推进和人口老龄化程度的加深,医保基金支付压力不断增大,迫切需要利用信息化手段加强对医保患者的处方管理和费用控制等现状;提出通过搭建电子处方监控系统平台实现共享数据库"处方中心",促进合理诊疗、合理用药,加强医保制度与医疗服务的协同发展,有效引导医疗机构主动规范诊疗行为;提高医保的精细化管理水平及智能化监管能力,防范了医保的欺诈、违规行为,确保基金的安全等建议。

This topic for the application of electronic prescription in the field of medical insurance settlement, with the propulsion of the integra- tion of medical insurance system and the deepening of population aging, the medical insurance fund payment pressure is increasing. Urgently need to strengthen prescription management and cost control to the patients with medical insurance by informatization tools. Through setting the platform of electronic prescription monitoring system to realize the sharing database ＂prescription center＂ . Promote reasonable treatment, ra- tional use of drugs, to achieve the coordinated development of medical insurance system and medical service, effectively guide the medical in- stitutions to standardize diagnosis and treatment behavior initiatively. Improve delicacy management level of medical insurance and intelligentize supervision capacity. Keep away cheat and illegal behaviour of medical insurance so as to insure t the fund＇ s safety.