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目的分析医保病案稽核中出现的问题,持续加强病历质控内涵管理。方法回顾性分析2014年全年各项病历质控检查记录,分析医保病历稽核中存在的问题及解决方案。结果稽核并跟踪的7000份病案中,存在问题的病案有1245份,不合格率17.8%。结论不断加强医保病案的内涵质量管理,合理使用医保基金,利用信息化扫除医保监管死角,提高医保病案稽核水平。
Objective To analyze the problems occurred in the audit of Medicare cases and to continuously strengthen the connotation management of medical records. Methods A retrospective analysis was made on the quality control records of various medical records in 2014, and the problems and solutions in medical records review were analyzed. Results Of the 7,000 medical records examined and tracked, 1245 were medical records with a failure rate of 17.8%. Conclusion Continuously strengthen the connotation and quality management of medical and health care cases, make rational use of medical insurance funds, use information to eliminate the dead ends of medical and health insurance supervision and improve the level of medical and medical examination.