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目的:探讨医疗保险异地就医即时结算问题及对策;方法:选取2015年至2016年来我院就诊的异地患者作为研究对象,2015年异地医疗保险结算采用常规方式,2016年对异地医疗保险结算方式进行改革和完善,采用升级方式。通过采用全面实施异地医保就医结算工作,分析异地医保病人在及时结算中存在的问题。结果:2015年和2016年异地患者对异地医保报销的知晓率无统计学意义(P>0.05);2016年关于医保报销难、费用审核难和核实查处难等问题均低于2015年(P<0.05)。结论:通过统一医保政策和医保信息系统、建立异地医保代办模式、对异地即时结算实施监督,可解决异地医疗保险及时结算中所面对的问题,减轻了异地患者的经济负担,给广大异地就诊的患者带来方便。
Objective: To explore the immediate settlement of medical insurance for medical treatment in different places and countermeasures; Methods: From 2015 to 2016 in our hospital for treatment of off-site patients as the object of study, 2015, remote medical insurance settlement using the conventional way, 2016 on the remote medical insurance settlement Reform and improvement, using the upgrade method. Through the full implementation of remote medical insurance for medical settlement, analysis of remote medical insurance in the timely settlement of existing problems. Results: In 2015 and 2016, the awareness rate of off-site health insurance reimbursement among non-local patients was not statistically significant (P> 0.05). In 2016, the reimbursement of health insurance was difficult, the costs were difficult to audit and the verification was difficult. 0.05). Conclusion: Through the unified medical insurance policy and medical insurance information system, the establishment of remote medical insurance agency model to supervise off-site instant settlement can solve the problems encountered in timely settlement of medical insurance in different places and reduce the economic burden of off-site patients to the vast majority of remote treatment The patient brings convenience.