医改背景下的医院医保管理策略研究

Research on the Management Strategy of Hospital Medical Insurance under the Background of Medical Reform

随着我国《关于进一步深化基本医疗保险支付方式改革的指导意见》的印发,使得我国医疗改革的推进势在必行。一直以来,如何将医疗保险充分落实,如何提升医院医保管理质量都是制约着医院发展的主要问题因素,但是在国家相关指导意见中,DRG(疾病诊断相关组)与DIP(国家医疗保障按病种分值付费)的出台能够充分解决上述问题。因此在这个基础上,该文基于医改背景下的医院医保管理分析,对于医疗改革过程中所出现的问题提出了相应的应对策略,为医院未来的良好发展奠定一个坚实的基础。

With the issuance of my country's"Guiding Opinions on Further Deepening the Reform of Basic Medical Insurance Payment Methods",it is imperative to promote our country's medical reform.For a long time,how to fully implement medical insurance and how to improve the quality of hospital medical insurance management are the main problems restricting the development of hospitals.However,in the relevant national guidance,the introduction of DRG(Disease Diagnosis Related Group)and DIP(National Medical Insurance Payment by Disease Points)can fully solve the above problems.Therefore,on this basis,based on the analysis of hospital medical insurance management under the background of medical reform,this paper puts forward corresponding coping strategies for the problems that arise in the process of medical reform which lays a solid foundation for the good development of the hospital in the future.