[1]李 冰,孙振宁,张 斌.“智慧医疗”模式下医院医保全流程结算体系的建立[J].医学信息,2023,36(14):38-43.[doi:10.3969/j.issn.1006-1959.2023.14.007]
 LI Bing,SUN Zhen-ning,ZHANG Bin.Establishment of Hospital Whole Process Settlement System Under the "Smart Medical" Mode[J].Journal of Medical Information,2023,36(14):38-43.[doi:10.3969/j.issn.1006-1959.2023.14.007]
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“智慧医疗”模式下医院医保全流程结算体系的建立()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年14期
页码:
38-43
栏目:
卫生管理信息学
出版日期:
2023-07-15

文章信息/Info

Title:
Establishment of Hospital Whole Process Settlement System Under the "Smart Medical" Mode
文章编号:
1006-1959(2023)14-0038-06
作者:
李 冰孙振宁张 斌
(甘肃省妇幼保健院信息中心,甘肃 兰州 730050)
Author(s):
LI BingSUN Zhen-ningZHANG Bin
(Information Center of Gansu Province Maternal and Child Health Hospital,Lanzhou 730050,Gansu,China)
关键词:
医疗保障信息平台入院登记目录对照出院结算
Keywords:
Medical security information platformAdmission registrationDirectory comparisonDischarge settlement
分类号:
R197
DOI:
10.3969/j.issn.1006-1959.2023.14.007
文献标志码:
B
摘要:
近年来,有关构建以患者为中心的智慧医疗服务体系理念逐步成为医院信息化建设的重点,全国医疗保障信息平台的上线为医院智慧化服务发展提供了契机。相比以往多个医保系统,新医疗保障平台解决了系统割裂、数据规范不统一的缺点,利用其兼容多种交易介质的特性和丰富的接口服务,医院能充分利用信息化手段对医保服务进行升级,构建以人工窗口、自助终端、移动终端为基础的一体化医保结算体系,有效解决了患者就诊期间多点往返排队等待的问题。本文以医保结算为例,阐述了该结算体系建立的原理和过程,探索了医保服务和信息技术融合的新途径,以期为智慧医院建设提供一种新思路。
Abstract:
In recent years, the concept of building a patient-centered intelligent medical service system has gradually become the focus of hospital informatization construction. The launch of the national medical security information platform has provided an opportunity for the development of hospital intelligent services. Compared with many medical insurance systems in the past, the new medical insurance platform has solved the shortcomings of system fragmentation and inconsistent data specifications. It is compatible with a variety of transaction media, so that the hospital can make full use of information technology to upgrade medical insurance services, built an integrated medical insurance settlement system based on artificial windows, self-service terminals and mobile terminals, and effectively solved the problem of patients running back and forth and often queuing up during medical treatment. Taking medical insurance settlement as an example, this paper expounds the principle and process of establishing the model settlement system, explores a new way of integrating medical insurance services and information technology, and provides a new idea for the construction of smart hospitals.

参考文献/References:

[1]李欣芳,张立强,张禧辰.智慧医保应用与发展的国际借鉴[J].中国医疗保险,2022(7):112-114.[2]唐颢,徐新.医疗保障信息平台医院端集成建设与应用[J].中国卫生信息管理杂志,2021,18(5):599-604,579.[3]程珊.医保信息标准化的问题及建议[J].劳动保障世界,2020(5):44.[3]陈磊,魏巍.基于DRGs的医保数据采集上传系统设计与应用[J].医学信息,2021,34(8):20-24.[4]乐敏.计算机网络用于医保系统信息化管理的实践探究[J].计算机产品与流通,2020(5):80.[5]单磊敬,郭晗,刘继良,等.军卫系统与医保智慧互联平台建设情况分析[J].海军医学杂志,2021,42(2):154-156.[6]程君,曹彤,王玉珍.“医保患者费用监控系统”在医院的应用[J].西北国防医学杂志,2011,32(6):497-498. [7]张雅男,唐佳骥.医保药品目录调整常态化背景下医院系统切换方案设计与实践[J].医学信息学杂志,2020,41(11):78-81.[8]孙翎,赵雨.基本医保“系统老龄化”的门限效应与地区差异[J].调研世界,2022(1):4-12.[9]朱瑞雪,汪丽.医疗机构医保智能审核系统的应用探究[J].科学与信息化,2021(11):138,141.[10]邢辉,邓提提.医院医保信息系统建设[J].电子技术与软件工程,2020(1):259-260.[11]何良泉,聂良刚等.智慧医疗医保服务系统的研发应用——以“互联网+”智慧医疗医保服务支付系统为例[J].网络安全技术与应用,2020(9):117-119.[12]田莹,安薇.医院药事管理持续改进中FMEA法应用效果分析[J].中国药业,2022,31(3):15-17.[13]李雪辉,李哲,袁琦.医疗付费“一件事”业务流程再造实践——以上海R医院为例[J].新会计,2021(12):27-30.[14]刘喆.基于区块链技术的电子政务的实现路径研究[D].曲阜:曲阜师范大学,2021.[15]王琪.智慧服务模式下公立医院助老服务的实践与优化[J].卫生经济研究,2022,39(2):32-34.[16]陈军坤.大型综合医院智能化设计[J].现代建筑电气,2020,11(5):28-32.[17]朱夏媛,吴号,葛彩英,等.智慧家庭医生优化协同模式在社区新型冠状病毒肺炎疫情联防联控中的应用[J].中华全科医师杂志,2020,19(4):280-283.[18]单飞跃,祝沁磊.基本医疗服务与基本医疗保险制度相协同的法治化路径[J].财经理论与实践,2022,43(2):147-153.[19]魏洋静.商业保险参与城乡居民大病医疗保险研究[J].经济研究导刊,2021(31):81-83.[20]崔立君.医院医疗保险管理中的问题及对策[J].中国管理信息化,2021,24(12):199-200.

更新日期/Last Update: 1900-01-01