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中文摘要: 目的:探讨县级综合医院临床药师参与医保控费管理的途径与方式。方法:查阅近年相关文献,分析临床药师参与医保控费管理的方式,同时结合该院临床药师参与医保控费管理的实践,提出人(患者)、物(药品)、机(信息系统)三闭环管理的工作模式。结果:县级综合医院临床药师通过参与人(患者)、物(药品)、机(信息系统)三闭环管理,充分参与医保控费管理的全过程,实现医保控费管理的目标。结论:县级综合医院临床药师通过参与“三闭环”管理,一方面保证了患者的用药安全,减轻了患者的经济负担,另一方面也降低了医保费用,节约了医保基金,实现了医保基金的可持续发展,并且促进了医院医疗技术的创新发展,实现了医、保、患三方互赢。
Abstract:Objective:To explore the method of clinical pharmacists participating in the fee control management of medical insurance in county-level general hospitals. Methods:Through reviewiing the relevant literatures in recent years,the ways in which the clinical pharmacists participated in the fee control management of medical insurance were analyze. Through combining the practice of the hospital,the working mode of three closed-loop management of human(patients),material(drugs),and machine(information system)was proposed. Results:The clinical pharmacists of county-level general hospitals could fully participate in the whole process of fee control management of medical insurance. Conclusions:By participating in the “three closed loop” management,the clinical pharmacists in the county-level general hospital ensure the safety of patients’ medications and reduce the economic burden of patients. On the other hand,they also reduce the cost of medical insurance,saving the medical insurance fund,and realiziing the medical insurance fund. Continued development.
keywords: county-level general hospital clinical pharmacist fee control of medical insurance closed-loop management
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基金项目:江苏省药学会天晴医院药学基金立项课题(Q2019166) 江苏省药学会天晴医院药学基金立项课题(Q2019166)
引用文本:
赵 明,陈中英*.县级综合医院临床药师参与医保控费管理探讨△[J].江苏卫生事业管理,2019,30(12):1567-1570.
Zhao Ming,Chen ZhongYing*.Discussion on the Participation of Clinical Pharmacists in the Management of Medical Insurance in County-level General Hospitals△[J].Jiangsu Health System Management,2019,30(12):1567-1570.
赵 明,陈中英*.县级综合医院临床药师参与医保控费管理探讨△[J].江苏卫生事业管理,2019,30(12):1567-1570.
Zhao Ming,Chen ZhongYing*.Discussion on the Participation of Clinical Pharmacists in the Management of Medical Insurance in County-level General Hospitals△[J].Jiangsu Health System Management,2019,30(12):1567-1570.