三甲医院医疗退费实证分析与对策探讨

Empirical analysis on refund management and its countermeasures in top tertiary hospitals

目的:分析三甲医院退费管理原因,提出解决思路与对策,优化医院服务流程。方法:通过对中山大学附属第一医院退费管理的数据分析、对比,探讨退费的原因,进而从医务、信息、内部控制角度讨论问题的解决方案。结果:退费量前3位的项目为检验、挂号和材料费;现金支付方式退费人次最多,银行卡支付方式退费占比最高;医生和患者原因导致的退费比重较大。结论:退费管理是医院财务风险管理的重要环节,需要多渠道、多途径优化医院服务流程,减少退费环节,并加强退费工作的日常监管。

Objectives:To analyze causes of refund in top tertiary hospital,to discuss the optimal solutions and optimize medical care process.Methods:By analyzing and comparing the data of refund management in the 1 st Hospital Affiliated to Sun Yat Sen University,countermeasures were discussed in aspects of medical affair management,information management and internal control.Results:Top 3 items of refund is laboratory fee,registration fee and materials fee.Cash refund is selected by most patient and bank card payment got the largest ratio to total fee.Doctor and patient caused most of refund.Conclusions:Refund management is the important part on hospital finance risk management and needs multi-coordination on process optimization,reduce process and strengthening normal monitoring.