目的: 通过开展问卷调查,了解江苏省医院医保管理工作现状,探讨存在问题,为完善医院医保管理部门职能,提高其管理水平提供建议和参考。方法: 设计调查问卷,面向江苏省13市的296家医疗机构开展调研,全面了解不同级别（三级、二级、一级）医院的医保管理水平。采用卡方检验,对比不同级别医院医保管理方式的差异。结果: 江苏省医院医保管理部门职能丰富,二级、一级医院医保管理水平需加强。建议： 医院应完善医保管理制度体系建设,加强管理人才队伍体系建设,推动院内医保医疗费用和医保行为联动管理。

Objective: Questionnaires were distributed to investigate the current situation of medical insurance management, in hospitals of Jiangsu Province, explore the problems and improve the functions of medical insurance management departments. Methods: The questionnaire was designed to investigate 296 hospitals (including level 3, level 2 and level 1 hospitals ) from 13 cities of Jiangsu Province. Chi-square test data statistical method was used to compare the differences of medical insurance management methods. Results: The medical insurance management departments in hospital of Jiangsu province are multifunctional, and the medical insurance management in level 2 and level 1 hospitals needs to be reinforced. Conclusion: The hospitals should improve the construction of medical insurance management system, strengthen the construction of management talent team, and promote the joint management of medical expenses and medical treatment in the hospital.