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中文摘要: 目的:探讨“行政MDT”管理模式在医院医保管理工作中的运用及效果。方法:比较实施医保“行政MDT”管理模式前(2016年度)与实施医保“行政MDT”管理模式后(2017年度)不同质控指标。结果:实施医保“行政MDT”管理模式后,医保患者平均出院时间、次均住院费用、平均住院日和住院药占比均降低,住院患者满意度提高,差异均有统计学意义。结论:实施医保“行政MDT”管理模式可以实现医保患者多科室联动管理,合理控制医保质控指标,节约医疗资源,控制医保基金不合理支出,提升医院管理水平。
Abstract:Objective:To investigate the application and effect of Administrative MDT management mode in hospital medical-insurance management. Methods:The quality control indexes were compared between 2016 (not carrying out administrative MDT in hospital medical-insurance management) and 2017(carrying out administrative MDT ). Results:After the implementation of administrative MDT,the average discharge time,the average hospitalization cost,the average hospitalization day and the proportion of hospitalized drugs of medical insurance patients were significantly decreased(t=75.85,7.319,9.277,19.373,P < 0.01),and the satisfaction rate of hospitalized patients was significantly increased(t=8.496,P < 0.01). Conclusions:The implementation of the “administrative MDT” management mode in hospital medical-insurance management can realize the coordinated management of multiple departments,reasonably control the quality control indexes of medical-insurance,save medical resources,control the unreasonable expenditure of medical-insurance funds,and improve the level of hospital management.
keywords: administrative MDT medical insurance management quality control indexes p atients’ satisfaction
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基金项目:江苏省医院协会医院管理创新研究基金面上指导课题(JSYGY-3-2018-185) 江苏省医院协会医院管理创新研究基金面上指导课题(JSYGY-3-2018-185)
引用文本:
李长江,林 宁,肖 瑾,万艳春,王君华.“行政MDT”在医院医保管理中的探索与运用△[J].江苏卫生事业管理,2019,30(5):622-625.
Li Changjiang,Lin Ning,Xiao Jin,Wan Yanchun,Wang Junhua.Exploration and Application of Administrative MDT in Hospital Medical Insurance Management△[J].Jiangsu Health System Management,2019,30(5):622-625.
李长江,林 宁,肖 瑾,万艳春,王君华.“行政MDT”在医院医保管理中的探索与运用△[J].江苏卫生事业管理,2019,30(5):622-625.
Li Changjiang,Lin Ning,Xiao Jin,Wan Yanchun,Wang Junhua.Exploration and Application of Administrative MDT in Hospital Medical Insurance Management△[J].Jiangsu Health System Management,2019,30(5):622-625.