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基于医保视角的公立医疗机构医用耗材准入策略研究OACSTPCD

Research on the access strategy research of medical consumables in public medical institutions from the perspective of healthcare security

中文摘要英文摘要

目的:基于医保管理角度,探讨公立医疗机构医用耗材准入机制,完善医用耗材准入顶层设计.方法:从医保监管、医保贯彻执行编码标准(简称贯标)、医保集采、医疗服务项目及价格和医保评审技术5个维度,设计医用耗材准入流程并提出针对性策略.结果:从加强医用耗材医保监管、落实医用耗材医保贯标、推进医用耗材医保集采落地、推动医保医疗服务项目和医疗服务价格项目发展以及积极开展卫生技术评估5个维度设计医用耗材准入流程,提出加强医保业务学习和培训、打造院内医用耗材准入多学科协作管理体系、探索建立适合我国医疗机构的卫生技术评估方法,推进医用耗材准入信息一体化建设的医用耗材准入针对性策略.结论:基于医保管理角度从理论上着重强调医保在公立医疗机构医用耗材准入中的核心位置,为医用耗材准入研究提供新思路,丰富医用耗材准入管理维度.

Objective:To explore the access mechanism of medical consumables in public medical institutions and to improve the top-level designs of medical consumables access based on the perspective of healthcare security management.Methods:From five dimensions of healthcare security supervision,implementation of coding standards(referred to as standard implementation),centralized procurement,medical service items and prices,and evaluation technologies,the access process of medical consumables was designed and targeted exploration strategies were proposed.Results:The access process for medical consumables is designed from five dimensions:strengthening the supervision of medical consumables and medical insurance,implementing the healthcare security standards for medical consumables,promoting the implementation of medical consumables healthcare security centralized procurement,promoting the development of healthcare security medical service projects and medical service price projects,and actively carrying out health technology assessment.The targeted strategies for the access of medical consumables were proposed of strengthening the learning and training of healthcare security business,building a multidisciplinary collaborative management system for medical consumables access in hospitals,exploring the establishment of health technology evaluation methods suitable for medical institutions in China and promoting the integration of medical consumables access information.Conclusion:Based on the perspective of healthcare security management,the core position of medical insurance in the access of medical consumables in public medical institutions was theoretically emphasized,which provides new ideas for the research of medical consumables access,and enriches the dimension of medical consumables access management.

严毅;郭武栋;周蒙;张弛;徐文科;王柱军

华中科技大学同济医学院附属协和医院医疗保险管理办公室 武汉 430022国家卫生健康委卫生发展研究中心 北京 100032山东大学第二附属医院医保办 济南 250033吉林大学白求恩第三医院医疗保险管理部 长春 130033皖南医学院第一附属医院国有资产管理科 芜湖 241001华中科技大学同济医学院附属协和医院儿科 武汉 430022

预防医学

公立医疗机构医疗保障医用耗材医用耗材准入

Public medical institutionHealthcare securityMedical consumablesMedical consumables access

《中国医学装备》 2024 (005)

118-122 / 5

国家自然科学基金(81700147);湖北省自然科学基金(2020CFB812) National Natural Science Foundation of China(81700147);Hubei Natural Science Foundation(2020CFB812)

10.3969/j.issn.1672-8270.2024.05.023

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