本文已被：浏览 1704次 下载 2次
中文摘要: 目的：探讨按病种付费对医疗机构提高控费意识，规范医疗行为，减少不合理医药费用，降低患者的医疗经济负担和按病种付费的执行初期暴露的问题。方法：对该院2015年按病种付费超支情况进行了原因分析，并通过政策宣讲、规范收费、规范治疗方案等方法控制过度医疗行为。结果：经过以上措施的落实，2016全年参与按病种付费的病案总体结算未超支。结论：科学合理的医保管理有利于在保证医疗安全的同时做到医疗费用的控制。
中文关键词: 按病种付费， 超定额，医保
Abstract:Objective：To discuss problems in improving medical institutes’ awareness of controlling costs, standardizing clinical behavior, reducing unreasonable medical cost, and reducing patients’ economic burden during initial implement of Diseases Related to Groups. It exposed many problems in the beginning of carrying out DRGs in hospitals. Methods：This paper analyzes the causes of overspending according to DRGs in our hospital in 2015，and managed to control excessive medical behavior by means of policy advocacy，standardization of fees，and regulation of treatment schemes. Results：after the implementation of the above measures，total settlement of medical records paid by DRGs for the full year 2016 without overrun. Conclusion：Scientific and reasonable medical insurance management is beneficial to ensure medical safety and keep medical expenses under control at the same time.
文章编号： 中图分类号： 文献标志码：
基金项目:
引用文本：
仲 珽,季亚男.按病种结算超定额费用原因分析及对策探讨[J].江苏卫生事业管理,2018,29(5):551-553.
Zhong Ting,Ji Yanan.Analysis on Reasons and Countermeasures to Exceeding Ration Cost Based on Disease Type[J].Jiangsu Health System Management,2018,29(5):551-553.
仲 珽,季亚男.按病种结算超定额费用原因分析及对策探讨[J].江苏卫生事业管理,2018,29(5):551-553.
Zhong Ting,Ji Yanan.Analysis on Reasons and Countermeasures to Exceeding Ration Cost Based on Disease Type[J].Jiangsu Health System Management,2018,29(5):551-553.
