惠州市三级医院住院病人医保结算政策分析

Analysis of Inpatient Medical Insurance Settlement Policy in Tertiary Hospitals in Huizhou

当前,惠州市存在居民医保病人难住院就诊,医院选择性收治病人,医院医保结算亏损严重等的问题。笔者参考某医院医保结算实际运营数据,针对惠州市三级医院住院病人医保结算政策,分析存在的问题,找出根源,提出惠州市三级医院住院病人医保结算政策的对策思路,使群众看上病、看好病,促进医院的可持续发展。

Currently, such issues come into being as difficulty of Huzhou residents with medical insurance in medical consultation and hospitalization, hospital＇ s selection in admitting resident patients and huge loss in medical insurance settle- ment in hospital. The authors try to find a way out by referring to the actual operation data from a hospital and aiming at Huizhou medical insurance settlement policy. They put forward the countermeasures, which may ensure the resident an easy access to medical consultation and promote the hospital＇ s sustainable development.