异地医保持卡患者出院结算管理流程优化与思考

Optimization and reflection of discharge settlement management processes for patients with non-local medical insurance cards

为了提升患者就医体验,减少异地患者因出院结算等待造成的时间及费用成本,北京市某三级甲等医院在异地医保患者跨省就医住院费用直接结算运行平稳的基础上,分析传统出院结算流程中存在的问题,通过加强医护人员自查能力、完善信息系统功能等措施多环节优化流程,在全市率先实现了异地持卡患者出院当日结算,目前成效显著,异地医保持卡患者平均结算时间从3.3天缩短到0.4天。下一步医院将依托智能化信息系统,持续为患者提供更加便捷的优质服务。

In order to decrease non-local patients cost of waiting discharge settlement and improve their medical experience, on the basis of cross-province medical insurance direct settlement of inpatients, a Grade Ⅲ hospital has analyzed the problems of original discharge settlement and optimized the process by different measures such as increasing the self-examination ability of nurses and doctors and improving hospital information system. As a result, the hospital has led the regulation that non-local patients having social security card could finish the medical insurance’s direct account settlement on discharge day. After performing the new procedure, the hospital account settlement time of non-local patients having social security cards has been significantly shortened from 3.3 days to 0.4 days. In the future, it is important for hospitals to continuously provide more convenient service depending on intelligent technology.