徐州市自2013年开始深入推行按病种收付费的医保支付方式改革,同时依托大数据平台的智能监控体系为其助力。本文梳理了典型地区医保智能监控的有益经验,介绍了徐州市基于大数据平台的按病种收付费智能监控体系建设的做法及成效,剖析了存在的问题,提出发展目标与展望,为完善按病种收付费的智能监控体系建设提供理论依据和实践参考。
Abstract
Since 2013, Xuzhou has carried out in-depth reform of healthcare security payment mode based on payment by disease type. At the same time, relying on the construction of intelligent monitoring system of big data platform, Xuzhou has assisted the reform of high-quality payment by disease type. This paper summarizes the beneficial experience of intelligent monitoring of healthcare security in typical areas, introduces the practice and effectiveness of Xuzhou's intelligent monitoring system of payment by disease based on big data platform, analyzes the existing problems, and puts forward the next development goals and prospects. This paper provides theoretical basis and practical reference for improving the construction of intelligent monitoring system based on disease collection and payment.
关键词
医保基金 /
智能监控 /
按病种收付费 /
徐州
Key words
healthcare security fund /
intelligent monitoring /
payment by disease /
Xuzhou
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参考文献
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基金
江苏高校哲学社会科学研究重大项目(2021SJZDA136); 徐州市医疗保险研究会基金项目(XYY2020-004)。