Qingdao: 6 number pilot projects cure the number settlement of the insurance policy 700 yuan of appendicitis operation is settled

Qingdao: 6 number pilot projects cure the number settlement of the insurance policy 700 yuan of appendicitis operation is settled
Qingdao: 6 number pilot projects cure the number settlement of the insurance policy 700 yuan of appendicitis operation is settled
On August 2, the reporter interviews to know, in order to control the medical fee, reduce patient's burden, since first half of the year, this city has implemented the single number settlement way, there are 6 class-B form number included in the pilot project in the first batch, there are 16 fixed hospitals, accorded with the patient of these single number no matter how much the last medical fee has been spented, only just need to pay the personal part while leaving hospital, the rest are undertaken with hospital by the medical insurance centre. The medical fee has been exceeded, individual needn't pay the bill more The reporter interviews to know, recently, the municipal office of people's society issues " notice on doing a good job of the relevant questions of number settlement of basic medical policy conscientiously ", define the single number settlement way is tried out since March 1, 2011. The class-B form number included in the pilot project in the first batch amounts to 6. Include single the intersection of number and implementation of pilot project in, close way by norm, close standard, define medical insurance the intersection of pool and King pay volume and individual and bear volume by norm. Effect an insurance patient take place actually expenses lower than, close not standard by norm, effect an insurance by the intersection of medical insurance and the intersection of pool and money patient close according to the intersection of quota and standard respectively; Go beyond the intersection of quota and the intersection of standard and above part, undertake by fixed hospital, effect an insurance the intersection of patient and actual cost lower than single the intersection of number and personal the intersection of quota and standard that settlement stipulate, according to calculating ordinarily in hospital. It is introduced, these 6 pieces of new number are the cataract operation respectively; Ovarian benign tumour operation; Uterus skin tumour excises the skill; Simple appendicitis operation; Skill that the artificial joint is replaced; The bile duct is guided, phosphorus - 32 sacculuses are put into treating (every service life is 20) . Take simple appendicitis operation as examples, in 401 hospitals, municipal hospitals, patient that the kind hospital of sea became the operation, if effect an insurance the worker only needs 900 yuan, effect an insurance residents need 1200 yuan; Pilot hospitals such as the cardiovascular disease hospital,etc. outside five medicine, Qingdao mound, effect an insurance the worker buts merely need to spend 700 yuan especially, residents need 900 yuan to effect an insurance. 16 the intersection of hospital and the intersection of total value and expenses different reporter interview, know according to all the intersection of hospital and actual conditions too, 16 hospitals such as municipal hospital, 401 hospitals, kind hospitals of sea, market central hospitals have launched the single number settlement pilot project at present. "It is not these 16 hospitals and each one that launch the number, but depend on situation of the hospital. " Municipal office of people's society relevant staff members tell reporters, the material that each hospital carries on the operation is different from standard at the same time, so the total value expenses are differentiated. The municipal office of people's society relevant person in charge says, single number is settled and planted while settling into the fee of material in the body that the standard does not include valuating alone, fee of products of fee of blood product, albumens and exceeding the berth fee that the ordinary berth is above expenses standard. And seeing that has civil servanted, health care cadred, left one's post at present personnel have already enjoyed the relevant medical subsidy policy, these three kinds of personnel do not list in the single number settlement of the new pilot project, still according to calculating ordinarily in hospital. At present, single number settlement will increase pilot number and hospital in the other districts successively next in course of launching a pilot project. In addition, besides single number settlement of these 6 class-B number implementation, and 18 pieces of class-A number implement single number settlement. It is reported class-A number every the intersection of hospital and the intersection of technical requirement and higher number, it closes ways and class-B forms to be number different, the patient, according to submitting an expense account ordinarily in hospital. What matter on earth the reporter is highlighted to chain single number settlement It is reported, single number settlement is monotonous to disease, clinical route similar, makes a diagnosis relative norm, expenses or treat the way of paying in which the way settles alone by single number as to the number that concentrate on. Include the intersection of medical insurance and the intersection of pool and fund in, wipe out single number of range, should possess, diagnose clearly at the same time, technology is ripe, treat the norm, curative effect is precise; The individual expenses are clear, the difference is not big and easy to fix; The number applied must be in the range of making a diagnosis that the health authorities of our institute permit; It is the operation number in principle, what is among them is issued by Chinese Health Ministry has number which standardizes clinic diagnosis route and quality control standard can include in the settlement range of single number preferably.


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