“双通道”管理机制下电子处方流转与医保线上结算分析

Analysis of Electronic Prescription Circulation and Medical Insurance Online Settlement under the“Dual Channel”Management Mechanism

运用问卷调查、关键知情人深度访谈等研究方法对深圳市2022年6月试点开展“双通道”电子处方流转与医保线上结算的量化数据、结算费用、满意度等实际运行情况进行调查,探索分析其有效杜绝假冒纸质处方、药店库存实时共享、药品价格透明化等优势以及处方流转覆盖面局限、处方审核环节障碍等不足之处,并提出打造统一化、标准化的处方流转模式,构建规范、高效的外购药品目录管理体系,强化信息隐私及数据安全等优化建议。

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the“dual channel”electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circulation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.