Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (8): 77-81.doi: 10.6040/j.issn.1671-7554.0.2018.1121

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Application design and practice of commercial insurance unified payment platform in a three class hospital

HAN Ye1, ZHU Xingguo1, WANG Chao2, KUANG Jun2   

  1. 1. Shandong Provincial Third Hospital, Jinan 250031, Shandong, China;
    2.WE DOCTOR Group(Zhejiang)Co. LTD, Hangzhou 311200, Zhejiang, China
  • Published:2022-09-27

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Abstract: At present, commercial insurance has a huge developmental space, and the relevant policies strongly support the cooperation between commercial insurance institutions and medical institutions. With the rapid development of “internet +” technology, it will be a trend to popularize the new online health care model, develop internet-based health services, and integrate health insurance with health management. The first commercial insurance payment platform in Shandong Province has been set up in Shandong Provincial Third Hospital, to realize rapid medical payment by several insurance companies. It has benchmark significance and is an effective exploration to promote medical reform, and has expanded the influence of the hospital in the industry and related management departments.

Key words: “Internet +” health care, Commercial health insurance, Payment platform, Fast payment

CLC Number: 

  • R197.1
[1] 黄阿红,方鹏骞,沈梦雪.医疗保险基金支出的人口学影响因素分析[J].中国卫生经济,2018,37(6):33-36. HUANG Ahong, FANG Pengqian, SHEN Mengxue, et al. Analysis on the impacts of demographic factors on medical insurance fund expenditure[J]. Chinese Health Economics, 2018, 37(6):33-36.
[2] 徐长生,张泽栋. 城镇化、老龄化及经济发展对我国医疗费用影响回归分析[J].中国卫生经济,2015,34(6):54-55. XU Changsheng, ZHANG Zedong. Regression analysis on the impacts of urbanization, aging population and economic development on the medical expense in China[J]. Chinese Health Economics, 2015, 34(6):54-55.
[3] 汪书怡,刘宝. 基本医疗保险异地就医结算和管理的思考[J].中国卫生资源,2018,21(4):346-350. WANG Shuyi, LIU Bao. Thoughts on offsite settlement and management of basic medical insurance[J]. Chinese Health Resources, 2018, 21(4):346-350.
[4] 张平, 徐兵, 甘筱青. 市场结构、医疗保险与医疗费用的关系研究[J]. 管理工程学报, 2018, 32(2):53-58. ZHANG Ping, XU Bing, GAN Xiaoqing. Relations on market structure, health insurance and medical expenses[J]. Journal of Industrial Engineering and Engineering Management, 2018, 32(2):53-58.
[5] Eggleston K, Ling L, Qingyue M,et al. Health service delivery in China:a literature review[J]. Health Econ,2007,17(2):149-165.
[6] 刘娅飞,邢娉,徐秀琴,等.山东多中心健康管理纵向观察队列[J].山东大学学报(医学版), 2017, 55(6):30-36. LIU Yafei, XING Ping, XU Xiuqin, et al. Shandong multi-center longitudinal cohort for health management:a brief introduction[J].Joumal of Shandong University(Health Sciences), 2017, 55(6):30-36.
[7] 董海松. “新国十条” 视角下的商业健康保险发展研究[J]. 金融与经济, 2015(11):77-81.
[8] 常朝娣, 陈敏. 分级诊疗服务信息技术应用探讨[J]. 中国医院管理, 2018, 38(4):50-52. CHANG Zhaodi, CHEN Min. Discussion on application of information technology in hierarchical medical service[J]. Chinese Hospital Management, 2018, 38(4):50-52.
[9] 于瑞均. 大病保险工作及与商保协同发展的规律性认识[J]. 中国医疗保险, 2014(10):29-31. doi: 10.3969/j.issn.1674-3830.2014.10.014. YU Ruijun. The rule of the co-development of serious illness insurance and commercial insurance[J]. China Health Insurance, 2014(10):29-31. doi: 10.3969/j.issn.1674-3830.2014.10.014.
[10] 纪娇, 高本林, 崔有文, 等. 信息化建设助推分级诊疗[J]. 中国卫生质量管理, 2018, 25(3):112-115. JI Jiao, GAO Benlin, CUI Youwen, et al. Study on the mode of informatization construction promoting hierarchical diagnosis and treatment[J]. Chinese Health Quality Management, 2018, 25(3):112-115.
[11] 刘强. “互联网+医疗”中外患者服务模式探析[J].中国卫生信息管理杂志,2015,12(4):335-337.
[12] 吴燕. 城镇化、老龄化、互联网和居民医疗支出对我国医疗卫生服务水平的影响分析[J]. 中国卫生经济, 2016, 35(1):66-68. WU Yan. Analysis on the impact of urbanization, aging, internet and resident medical expenses on the service level of health care in China[J]. Chinese Health Economics, 2016, 35(1):66-68.
[13] 邹文杰, 蔡鹏鸿. 公共卫生支出、人口聚集与医疗卫生服务均等化[J]. 上海财经大学学报, 2015, 17(3):59-67. ZOU Wenjie, CAI Penghong. Public health expenditures, population aggregation and the equalization of basic public health services[J]. Journal of Shanghai University of Finance and Economics, 2015, 17(3):59-67.
[14] 廖杰远.让医疗“移动”起来解决行业痛点[J].浙商,2016(12):31.
[15] 田稳帅. 影响大病保险可持续发展的因素与发展策略[J].商情,2016(21):68.
[16] 郭翔,邵蓉.美国健康储蓄账户对我国医保个人账户的启示[J].现代商贸工业,2016,37(6):132-134.
[17] 赵斌, 文裕慧. 国际医疗储蓄账户计划设计结构及效果述评[J]. 中国卫生经济, 2012, 31(7):93-96. ZHAO Bin, WEN Yuhui. Review on design and performance of international medical savings accounts plan[J]. Chinese Health Economics, 2012, 31(7):93-96.
[18] 董曙辉. 关于大病保险筹资与保障范围的思考[J]. 中国医疗保险, 2013(4):9-11. doi: 10.369/j.issn.1674-3830.2013.4.2. DONG Shuhui. Ponder on the financing and coverage of serious illness insurance[J]. China Health Insurance, 2013(4):9-11. doi: 10.369/j.issn.1674-3830.2013.4.2.
[19] 徐昆. 商业健康保险与医疗大数据对接交互系统研究[J]. 金融理论与实践, 2018(7):103-108. doi: CNKI:SUN:JRLS.0.2018-07-018. XU Kun. The system of exchange between commercial health insurance providers and healthcare big data[J]. Financial Theory & Practice, 2018(7):103-108. doi: CNKI:SUN:JRLS.0.2018-07-018.
[20] 李涛.我国商业健康保险的发展策略研究[J].金融经济(理论版),2015(22):66-68.
[21] 杨正茂.中国商业健康保险与社会医疗保险协调发展研究[J].中国市场,2014(50):108-110. doi: 10.3969/j.issn.1005-6432.2014.50.027.
[1] CHAO Jianqian, CAI Ruixue. Application of health management in social health insurance in the context of Healthy China [J]. Journal of Shandong University (Health Sciences), 2019, 57(8): 53-60.
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