[1]陈明艳,顾亚斌,王煜昊,等.特殊医用材料的医保精细化管理研究[J].卫生经济研究,2019,(07):14-16.
 CHEN Ming-yan,GU Ya-bin,WANG Yu-hao,et al.Research on the fine management of medical insurance for special medical materials[J].Journal Press of Health Economics Research,2019,(07):14-16.
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特殊医用材料的医保精细化管理研究
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
期数:
2019年07期
页码:
14-16
栏目:
聚焦医改
出版日期:
2019-06-24

文章信息/Info

Title:
Research on the fine management of medical insurance for special medical materials
作者:
陈明艳1顾亚斌2王煜昊1徐 伟1
1.中国药科大学国际医药商学院,江苏 南京 211198
2.江苏省苏州市人力资源和社会保障局,江苏 苏州 215000
Author(s):
CHEN Ming-yanGU Ya-binWANG Yu-haoXU Wei
School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing Jiangsu 211198,China
关键词:
特殊医用材料医保精细化管理物价编码医保支付标准
Keywords:
special medical materialsfine management of medical insuranceprice codingmedical insurance payment standard
分类号:
R19
文献标志码:
A
摘要:
目的:分析特殊医用材料在医保管理中的问题,为医保信息化建设及精细化管理提供参考。方法:从物价编码的对应、支付标准的制定、医保数据库的调整三方面展开现状及对策研究。结果:特殊医用材料存在物价编码对应混乱、分类标准多样、医保支付标准制定方法不统一等问题。结论:特殊医用材料的医保管理较混乱,建议从医保数据库的建设、特殊医用材料的分类等方面进行完善。
Abstract:
Objective To analyze the problems of special medical materials in medical insurance management,and provide reference for medical insurance information construction and refined management. Methods The status-quo and countermeasures were studied from the correspondence of price coding,the formulation of payment standards,and the adjustment of medical insurance database. Results: Special medical materials have problems such as price confusion,diversified classification standards,and inconsistent methods for formulating medical insurance payment standards. Conclusion The medical insurance management of special medical materials is confusing. It is recommended to improve from the construction of medical insurance database and the classification of special medical materials.

参考文献/References:

[1] 李孟林,顾亚斌,陈明艳,等.特殊医用材料医保结付管理研究[J].卫生经济研究,2018(9):49-51.
[2] 赖淑萍,谭友文,威以萍,等.一次性医用耗材按材质分类编码探讨[J].卫生经济研究,2015(2):11-14.
[3] 常峰,崔鹏磊,夏强,等.德国药品参考价格体系对构建我国医保支付标准的启示[J].中国卫生政策研究,2015,8(7):55-60.
[4] 陈敬,赵熙子,赵亮,等.德国、日本和我国台湾地区药品价格规制经验及启示[J].中国药房,2017,28(25):3464-3467.
[5] 常峰,崔鹏磊,夏强,等.日本医保药品支付价格调整机制对我国的启示[J].中国医药工业杂志,2015,46(8):915-920.

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[1]李孟林,顾亚斌,陈明艳,等.特殊医用材料医保结付管理研究[J].卫生经济研究,2018,(09):49.
 LI Meng-lin,GU Ya-bin,CHEN Ming-yan,et al.Research on Medical Insurance Payment Management of Special Medical Materials[J].Journal Press of Health Economics Research,2018,(07):49.
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更新日期/Last Update: 2019-06-24