基于DRG思路的生育保险费用管理实践与探索

Practice and Exploration of the Maternity Insurance Management Based on DRG

基于疾病诊断相关分组(DRG)疾病分组管理思路,有针对性地对比不同医疗组诊治同疾病组差异、生育保险费用控制情况,为内部规范临床医疗行为、有效控制费用提供数据支撑;基于数据分析,提升与医保管理部门沟通力,为进一步完善生育保险支付政策提供建议。

Based on management ideas for DRG disease grouping, it targeted at comparing the differences and maternity insur- ance control status of different medical groups within the same disease, provided data support on internal standard practical medical treatment and effectively controlling expenses; based on data analysis, the communication with the medical insurance management de- partment was improved to provide suggestion on further implementation for maternity insurance.