DRGs付费模式下医院医保精细化管理实践

Delicacy management of medical insurance in hospitals under the DRGs payment mode

DRGs盈亏是医院DRGs付费管理的重点和难点,医保办通过对DRGs的盈亏数据进行分解,深层次地发掘医院DRGs盈亏的原因。通过分析亏损原因,发现医院DRGs付费存在的问题并加以解决,提升医院医保精细化管理水平,同时减少医院亏损。

Under the DRGs payment management of hospitals,the profit and loss of DRGs become significant and difficult to cope with as well.The Hospital Medical Insurance Office deeply explored the reasons of the profit and loss of DRGs through analyzing the data of DRGs profit and loss.By means of analyzing what caused the loss,problems in DRGs payment were found and solved so that the delicacy management of medical insurance in hospitals was improved and the loss of the hospitals was reduced.