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目的探讨异地医保稽核制度的完善对于提高医保体系效率的意义。方法通过对我国现行异地医保的稽核方式存在的漏洞和弊端进行分析,同时提出加强监督的相关建议。结果目前异地医保稽核方式存在着实施困难、网络不健全、各地区之间合作性差,合作标准不统一等弊端,需要不断加强网络建设、建立全国性的医疗记录登记、实施全国统一的医保政策、甚至建立统一的医保体系等是进一步加强医保监督机制的有效措施。结论健全的监督机制对于提高异地就医结算的的审核效率、审核意义重大。
Objective To explore the significance of improving the system of medical insurance in different places for improving the efficiency of medical insurance system. Methods By analyzing the existing loopholes and malpractices in our country’s existing medical insurance in different places, we also put forward some suggestions to strengthen the supervision. Results At present, there are some shortcomings in implementation of the medical insurance auditing system in different places: the network is not perfect; the cooperation between different regions is poor; the cooperation standards are not uniform; and the network construction needs to be continuously strengthened; a nationwide medical record should be registered; Even the establishment of a unified health insurance system is an effective measure to further strengthen the health insurance supervision mechanism. Conclusion The sound supervision mechanism is of great significance to improve the efficiency of the audit of medical settlement in different places.