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门诊医疗保险是城镇职工基本医疗保险的一个重要的组成部分,而门诊医疗保险就医管理在门诊医疗保险运行中又占据着重要的位置。一个统筹地区门诊医疗保险就医管理模式的合理及完善与否,在很大程度上影响着门诊医疗保险的就医管理效果和运行成败。为此,我们对运行一年来的宁波市市级统筹门诊医疗保险就医管理情况进行了反思和调研分析,以求从就医管理模式着手,针对参保人员门诊就医中存在的问题,就如何进一步推进门诊就医管理,提高管理效果进行有益的探索。
Out-patient medical insurance is an important part of basic medical insurance for urban workers, and medical out-patient medical insurance occupies an important position in out-patient medical insurance. The rationality and perfection of medical management mode of outpatient medical insurance in a co-ordinating area greatly affect the medical management effect and operation success of outpatient medical insurance. To this end, we conducted a review and investigation on the management of medical insurance for co-ordinating outpatients in Ningbo Municipality during the one-year operation in order to proceed with the mode of medical management and how to further promote the existing problems in the outpatient service for the insured persons Out-patient medical management, improve management effectiveness of useful exploration.