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目的在兼顾医院、患者、医疗保险机构三方利益的基础上,探索健全医疗质量管理方法,控制医疗费用不合理增长,引导医疗行为和合理医疗消费,提高医疗质量水平。方法对所有出院病案进行病例分型,通过病例分型进行目标管理、病案质量管理、临床路径管理。结果控制了医疗费用不合理增长,提高了医疗质量和病案内涵质量,保证了临床路径的顺利开展。结论病例分型兼顾了医疗质量和效益两方面的管理功能,能客观、公正地评价医疗质量,是先进、科学的医疗质量管理模式。
Objective To explore and improve the medical quality management methods based on the tripartite interests of hospitals, patients and medical insurance institutions, to control the unreasonable increase of medical expenses, to guide medical behaviors and rational medical consumption, and to improve the quality of medical treatment. Methods All the discharged cases were classified according to the types of cases and objective management, medical record quality management and clinical path management were carried out by case classification. As a result, the unreasonable increase of medical expenses was controlled, the medical quality and the connotation quality of the medical record were improved, which ensured the smooth development of the clinical path. Conclusion The classification of cases takes into account the management functions of both medical quality and benefit, and can objectively and impartially evaluate the quality of medical care. It is an advanced and scientific medical quality management model.