Practice of information technology construction in a hospital based on the reform of ambulatory patient groups payment reform
10.3760/cma.j.cn111325-20240910-00769
- VernacularTitle:某院基于门诊病例分组付费改革的信息化建设实践
- Author:
Chenqi ZHOU
1
;
Shanghua XIONG
;
Bangbiao GE
;
Jiecong YAO
;
Yuqing HUANG
;
Hongyi ZHANG
;
Yanhong HUANG
;
Jiayi GUO
Author Information
1. 浙江大学医学院附属金华医院信息中心，金华 321000
- Publication Type:Journal Article
- Keywords:
Information management;
Medical insurance payment;
Ambulatory patient groups;
Hospital informatization;
Operations management;
Supervision of medical insur
- From:
Chinese Journal of Hospital Administration
2025;41(5):350-353
- CountryChina
- Language:Chinese
-
Abstract:
With the continuous deepening of medical insurance payment reform, the implementation of the ambulatory patient groups(APG) based point system for payment has posed new challenges to the quality management of outpatient electronic medical record writing, as well as the supervision and operation management of outpatient costs in hospitals. A certain hospital began information technology construction in July 2021. By introducing diagnostic grouping functions into the outpatient electronic medical record system, the hospital strengthened the standardization of medical record writing. It also established an intelligent audit system for medical insurance costs to conduct full-process supervision of outpatient medical expenses and developed an intelligent operation analysis system for outpatient APG to provide a basis for hospital operation management decisions and performance distribution. These measures effectively improved the quality of outpatient medical record, reduced outpatient medical costs, and optimized their structure. The application of the intelligent medical insurance audit system also effectively prevented certain non-compliant issues in medical insurance payments, which can provide a reference for other medical institutions.
