杭州市三甲医院医保从业人员现状调查与分析(1)
[摘要] 目的 了解杭州市三甲医院医保从业人员现状，发现问题并提出合理化的建议和对策。 方法 设计半结构式问卷对2019年2月杭州市全部21家三甲医院的140例医保从业人员现状进行问卷调查。 结果 21家三甲医院医保从业人员与床位数之比为1∶242;医保工作年限>5年占49%，≤5年占51%;76%的人员专业背景为临床医护类;72%的人员学历为本科;59%的人员为中级职称;医保从业人员继续教育制度基本缺失，职称建设体制基本处于空白。 结论 医院医保从业人员主要存在人员配置不足、继续教育制度和职称建设体制缺失的问题。在医疗保险制度快速发展的今天，需要医院和相关主管部门重视医保人才队伍的建设，保证新一轮医改的顺利实施。
[关键词] 三甲医院;医保从业人员;现状
[中图分类号] R197.32 [文献标识码] B [文章编号] 1673-9701(2019)35-0122-04
Investigation and analysis of current situation of medical insurance practitioners in Grade ⅢA hospitals in Hangzhou
REN Jinwen ZHU Jiaying
Zhejiang People's Hospital， Hangzhou 310014， China
[Abstract] Objective To understand the current situation of medical insurance practitioners in the Grade ⅢA hospitals in Hangzhou in order to find out the problems and propose rational suggestions and countermeasures. Methods A semi-structured questionnaire was designed to investigate the current situation of 140 medical insurance practitioners in all 21 Grade ⅢA hospitals in Hangzhou in February 2019. Results The ratio of medical insurance practitioners to bed in the 21 Grade ⅢA hospitals was 1：242. The percentage of medical insurance practitioners working for >5 years was 49% and the percentage of medical insurance practitioners working for≤5 years was 51%. 76% of the personnel’s professional background was clinical medicine. 72% of the personnel’s qualification was undergraduate; 59% of the personnel’s titles were intermediate; The continuing education system for medical insurance practitioners was lacking and the professional title construction system was basically blank. Conclusion The hospital medical insurance practitioners mainly have the problems of insufficient staffing and lack of continuing education system and professional title construction system. Today， with the rapid development of the medical insurance system， hospitals and relevant competent authorities need to attach importance to the construction of medical insurance talents to ensure the smooth implementation of a new round of medical reform.
[Key words] Grade ⅢA hospitals; Medical insurance practitioners; Current situation
醫院医保从业人员不仅是各项医保政策制度实施的宣传员、排头兵，也是医保基金安全的监督者、守护人，据不完全统计，目前我国医院医保从业人员有30万[1]，与庞大的参保人群和巨额的医保基金支出相比[2]，医保从业人员严重不足。根据国家医保局发布的数据显示[3]，2018年全国基本医疗保险参保人数为134 459万人，与医院医保从业人员之比为4482∶1。2018年全年基本医疗保险基金总支出为17 822亿元，意味着平均每一位医院医保从业人员一年需要对594.07万元的医保基金支出进行监管。, http://www.100md.com(任晋文 朱佳英)
[关键词] 三甲医院;医保从业人员;现状
[中图分类号] R197.32 [文献标识码] B [文章编号] 1673-9701(2019)35-0122-04
Investigation and analysis of current situation of medical insurance practitioners in Grade ⅢA hospitals in Hangzhou
REN Jinwen ZHU Jiaying
Zhejiang People's Hospital， Hangzhou 310014， China
[Abstract] Objective To understand the current situation of medical insurance practitioners in the Grade ⅢA hospitals in Hangzhou in order to find out the problems and propose rational suggestions and countermeasures. Methods A semi-structured questionnaire was designed to investigate the current situation of 140 medical insurance practitioners in all 21 Grade ⅢA hospitals in Hangzhou in February 2019. Results The ratio of medical insurance practitioners to bed in the 21 Grade ⅢA hospitals was 1：242. The percentage of medical insurance practitioners working for >5 years was 49% and the percentage of medical insurance practitioners working for≤5 years was 51%. 76% of the personnel’s professional background was clinical medicine. 72% of the personnel’s qualification was undergraduate; 59% of the personnel’s titles were intermediate; The continuing education system for medical insurance practitioners was lacking and the professional title construction system was basically blank. Conclusion The hospital medical insurance practitioners mainly have the problems of insufficient staffing and lack of continuing education system and professional title construction system. Today， with the rapid development of the medical insurance system， hospitals and relevant competent authorities need to attach importance to the construction of medical insurance talents to ensure the smooth implementation of a new round of medical reform.
[Key words] Grade ⅢA hospitals; Medical insurance practitioners; Current situation
醫院医保从业人员不仅是各项医保政策制度实施的宣传员、排头兵，也是医保基金安全的监督者、守护人，据不完全统计，目前我国医院医保从业人员有30万[1]，与庞大的参保人群和巨额的医保基金支出相比[2]，医保从业人员严重不足。根据国家医保局发布的数据显示[3]，2018年全国基本医疗保险参保人数为134 459万人，与医院医保从业人员之比为4482∶1。2018年全年基本医疗保险基金总支出为17 822亿元，意味着平均每一位医院医保从业人员一年需要对594.07万元的医保基金支出进行监管。, http://www.100md.com(任晋文 朱佳英)