Deepening healthcare reform highlights the importance of medical services pricing adjustment, and the imperativeness to strengthen the informationized management of such pricing.With this concept in mind, the authors analyzed the problems and causes of the current management on medical service pricing informatization at public hospitals, and discussed the construction strategy of an intelligent error correction system in this regard. That is, to develop a technical process from the four aspects of software flow, interface flow, project rules, and reporting system. This system is designed with such functions as inpatient cost inquiry, inpatient information, price adjustment analysis, price feedback record statistics and inquiries over the hospitalization expense ceiling, as well as inpatient cost omission inquiry.This paper also discussed the construction of a platform to transform the knowledge of pricing policy into the knowledge base of medical service pricing, in order to improve the level of medical pricing management, promote the efficiency of hospital operation and management, and reduce the burden of patients.

By analyzing the medical insurance policy, the medical insurance audit business and the intelligent monitoring requirements put forward by the medical reform, the intelligent examination and approval database was established, and the system process reengineering was carried out in conjunction with HIS, LIS and electronic medical record systems. The intelligent medical insurance audit information system was successfully developed and implemented, which realized automatic review of the medical qualifications of trauma patients, automatic audit of blood product items, automatic verification of high-cost fees, automatic review of repeated hospitalizations within 10 days, and automatic update of discharge diagnosis, as well as drug( diagnosis/treatment) project limits( excessive) early warning and other core business functions. The system meets the actual needs of the quality and efficiency of data management in medical insurance audit, providing basic platform and data support for standardizing doctors′diagnosis and treatment behavior and avoiding hospital risks.

目的:探讨护理组长在护理管理质控链中的作用。方法:将8个病区随机分为试点组和对照组各4个病区。对照组采用护士长统一管理的传统模式;试点组设立护理组长,形成分层管理模式质控链。比较两组护理质量及患者满意度。结果:两组护理质量和患者满意度比较差异有统计学意义(P<0.01,P<0.05)。结论:护理组长是病区护理管理质控链的中坚力量,担负着承上启下的桥梁作用,在质控链中强化护理组长的管理作用可实现护理层级管理、确保护理安全、提高患者满意度。

目的:加强医院病历费用审核,维护医患双方合法权益,延伸护理管理内涵。方法:由临床经验丰富的护士长承担专职费用审核人员,运用计算机管理系统,进行患者费用审核,延伸护理管理内涵。结果:应用护理管理的方法进行医院费用审核管理,规范医疗护理病历记录,提高记费准确率。结论:由熟悉医疗价格项目的护士长进行专职审核,加强了物价病历记录的监管力度,维护了医患双方权益,延伸了护理管理内涵,提升了医院形象。