医保DRG/DIP付费视角下医院信息化建设现状与实践

Current status and practice of hospital informatization from the perspective of medical insurance DRG/DIP payment

信息化建设是医院实现DRG/DIP付费精细化管理的关键。本文梳理分析了医院协同推进DRG/DIP付费改革的任务,总结医院DRG/DIP信息化建设现状,提出医院DRG/DIP信息化建设重点在于与医保部门信息系统的衔接,需以数据为基础,围绕保障医疗服务质量和提升病案数据质量两条主线开展运营分析,并重视医保基金监管稽核,从而为DRG/DIP改革提供全方位的信息化支撑。

Information construction is the key to realize the fine management of DRG/DIP payment in hospitals.In this paper,the task of hospital's collaborative promotion of DRG/DIP payment reform was analyzed,and the current situation of information construction for DRG/DIP payment in hospitals was summarized.It is proposed that the emphasis of hospital DRG/DIP information construction is to link up with the information system of the medical insurance department,and it is necessary to carry out data-based operational analysis around the two main lines of ensuring medical service quality while improving medical record data quality,and to pay attention to the supervision and audit direction of medical insurance funds,so as to provide all-round information support for DRG/DIP payment reform.