苏州市医疗保险药品目录管理实践与思考

Management Practice and Thinking of Medical Insurance Medicine Catalog in Suzhou

随着医保制度的全民覆盖、医保待遇的不断提高、参保人员医药需求的日益增长,医疗保险药品目录管理的重要性日益凸显,管理要求也越来越高。苏州市在严格贯彻国家、省医疗保险药品目录的基础上,通过特色项目管理、信息化维护和系统实时监管,建立起以需求为导向、以政策为核心、以数据为基础、以信息化为手段的行之有效的医疗保险药品库管理体系。本文对苏州市医疗保险药品库管理进行系统介绍,分析目前管理存在的困难,并提出对策建议。

With the full coverage of the medical insurance system,continuous improvement of the medical insurance benefi ts and the increasing demand of medical needs,the importance of the medical insurance medicine catalog has become increasingly prominent,and the management requirements are also getting higher.On the basis of strict implementation of national and provincial medical insurance medicine catalogs,Suzhou has established a demand-oriented,policy-based,data-based and informatization-driven eff ective medical insurance medicine catalog management system.This article systematically introduced the medical insurance medicine catalog in Suzhou,analyzed the existing diffi culties in the management,and proposed the suggestion