肿瘤放化疗门诊特种病备案管理探讨

Discussion on Implementation of Medical Insurance Registration Policy in Outpatient Radio-chemotherapy for Malignant Tumor

门诊特种病政策是医疗保险政策的重要组成部分,北京市于2016年11月推行特种病备案登记制度。笔者就政策实施的基本工作背景、院内管理思路和工作成效进行分析,并就门诊特种病人群逐渐放大与有限的基金规模、肿瘤放化疗人群的准入退出标准、医保医师的角色和管理定位等工作难点进行分析,提出建议。

Clinic special disease policy is an important part of medical insurance policy, and the hospital- based autonomous registration scheme was implemented in November 2016 across Beijing district. The author analyzes the implementation of the policy background ,hospital management ideas and work achievements.Then,the author analyses the difficulties we may meet on work,such as special outpatient gradually enlarged with limited fund size, admittance standard and exit criteria of tumor radiotherapy and chemotherapy, the role and management orientation of health care physicians, and give suggestion.