Research on the Reconstruction and Optimization of the Public Hospital Medical Insurance Management System from a Standardization Perspective
Sirou Guo,Yahong Li,Yi Tian
1.Tianjin medical university cancer institute & Hospital Medical Insurance Office, 300060; 2.The second hospital of Tianjin medical university Medical Insurance Office, 300060
Abstract:As China’s healthcare reform deepens,the pace of medical insurance payment method reform has accelerated,and the level of precision in medical insurance supervision has continued to improve. Medical institutions are facing multiple challenges in medical insurance management. Based on the actual management practices of medical institutions,this study employs methods such as literature review,questionnaire surveys,and structured interviews to systematically analyze the impact of medical insurance policies on hospital operations,identify the current status and prominent issues in hospital medical insurance management,construct a scientifically feasible standardized system for medical insurance management,and propose recommendations for optimizing medical insurance management. The aim is to support medical institutions in standardizing their medical insurance service behaviors,improving management quality and efficiency,and contributing to a win-win-win outcome for healthcare,medical insurance,and patients.
Keywords : Medical Insurance;Medical Insurance Management;Medical Insurance Fund
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