ABSTRACT
Objective To analyze the present situation and characteristics of the offsite real-time settlement patients based on the statistics of the hospital's information of such patients, for the purpose of work improvement.Methods Retrospective analysis was made on the hospitalization cost and the payment period of 1 151 offsite real-time settlement medical insurance patients in the hospital. Descriptive method was used as the statistical methods to analyze the data. Results The patients came from various places, mainly from Hebei province;most of them aged 51 years or older; mostly covered by medical insurance for urban workers; the largest proportion was retirees; their visits centered on E. N. T. department; the reimbursement policies of various provinces differed sharply, and the reimbursement period tended to be long.Conclusions Senile patients deserve greater attention to improve their service and environment; the hierarchical medical system should play a greater role for rational use of characteristic disciplines; establish the medical partnerships should be based on the Beijing-Tianjin-Hebei integration; greater efforts are required to communicate the medical insurance policy for greater coverage of the beneficiaries; commercial insurance should be introduced in the practice, to relieve the burden of advanced payments on medical institutions;reimbursement policy needs to be consistent,to ensure the fairness and universality of the basic medical insurance system.
ABSTRACT
It is one of the hot spots in recent years to provide immediate settlement services for a large number of remote medical groups.Based on the related concepts and the design of the national policy,it clarifies the connotation and types of remote medical treatment and remote medical treatment,analyzes the existing policy orientation,and puts forward the main problems of real-time settlement in different places.In the new stage of the medical and health system reform,combined with the relevant reform and practice,it proposes the realization path of real-time settlement of medical treatment in different places.
ABSTRACT
Objective To realize real-time medical insurance settlement system of Xi'an based on Outpatient One Card Solution to reduce the errors due to artificial accounting.Methods The system was developed with C# language and Oracle 10g, based on interface function dynamic library calling rule and HIS data structure requirements provided by Xi'an municipal medical insurance center.Results The system realized real-time settlement of the patient with medical insurance card.Conclusion The system simplifies medical insurance outpatient treatment flow and implements data communication.
ABSTRACT
Analyze the problems of medical insurance real-time settlement in outpatient department.Explore the situation of stringent management of health medical insurance agencies,accuracy of the information,significant increasing costs that medical insurance agencies refused to pay and severe environment to doctors.And management strategy such as regulating doctors' behavior strictly,upgrading hospital information systems,increasing hospital staff to excavate the hospital potential and publicizing the new policy of medical insurance comprehensively.