Diseases distribution and data analysis of children patients with allopatry direct settlement of medical insurance
10.3760/cma.j.issn.1000-6672.2019.03.005
- VernacularTitle:儿童异地医保直接结算患者病种分布及数据分析
- Author:
Chunxia NA
1
;
Dongzi WANG
;
Boqian FU
;
Zhihui LIU
Author Information
1. 国家儿童医学中心(北京) 首都医科大学附属北京儿童医院医疗保险办公室 100045
- Keywords:
Insurance,hospitalization;
Allopatry medical insurance;
Settlement;
Diseases
- From:
Chinese Journal of Hospital Administration
2019;35(3):194-197
- CountryChina
- Language:Chinese
-
Abstract:
Objective To research the performance of direct settlement for allopatry medical insurance at a tertiary specialized children′s hospital in Beijing, and to analyze the basics of these inpatients and the structural characteristics of their diseases, for basis and suggestions for improving the policy of direct settlement of allopatry medical insurance. Methods A statistical description of direct settlement data was made for allopatry medical insurance at this hospital from August 2017 to July 2018, to study the age, hometown, attribute, distribution of inpatient departments and disease distribution of these children. Results The patients mainly came upon referrals, preschool children in most cases. The average daily hospitalization cost of the disease was high relatively, and the number of hospitalizations was high as well. Compared with children inpatients in Beijing, these patients tend to come for surgical treatment for malignant tumors and congenital diseases.Conclusions The allopatry direct settlement of children′s medical insurance settlement is found mostly with diseases those are complicated and severe. The management of such settlement can be improved by cooperating with their local institutions in advance, data checking in the course, simplifying the formalities for special diseases, and the differential reimbursement ratio for these patients.
