摘要
通过评估我院原特殊病种申办服务流程存在的薄弱环节,探讨医院内特殊病种申办服务流程优化实践,措施包括:与医保机构深入沟通,取消申报特殊病种需提供复印病历资料的要求;依托电子病历系统改变医保科通知申办模式,由临床医生负责通知申办;建立"特病申办管理"的医保信息平台和特病申办流程优化的全方位培训与宣传方案等。流程优化后,医院内特殊病种申办环节由5个缩减至2个,患方申办时间由原来出院一周后申办优化为出院时即可申办,避免了出院后回医院申办所需交通及复印等经济支出;院方通知申办的医保服务工作效率提高,符合申办条件的患者特病申办通知无遗漏;患者及家属对特病申办的医保服务满意度明显提高。
To explore the optimization of special disease application process by evaluating the weak chains in the old process in our hospital. The approaches for optimization included, 1.To conduct in-depth communication with the medical insurance agencies, to cancel the requirements of medical record copy for declaration of special diseases; 2.To change informing by department of medical insurance to informing by doctors relying on electronic medical record system; 3.Establishing o the health insurance information platform of ＂special disease application and management＂ and comprehensive training and publicity programs for special disease application process optimization. After the optimization, the number of special disease application procedures decreased from 5 to 2. Patients could apply at discharge instead of one week after discharge, saving the cost for transportation and copying of coming back to hospital. The efficiency of medical insurance service increased and no patients meeting the requirements of application were missed. The satisfaction of patients and their families on the medical insurance services for special disease application significantly improved.
作者
姚文英
吴巍
钱小芳
陈敏芬
YAO Wen-ying WU Wei Qian Xiao-fang Chert Min-fen(Huzhou Central Hospita)
出处
《医院管理论坛》
2018年第3期43-45,19,共4页
Hospital Management Forum
关键词
医院
特殊病种
医保服务
流程优化
Hospitals
Special diseases
Medical insurance services
Process optimization
