The process and prospect of information construction of immediate reimbursement of inter-provincial healthcare in China

Corresponding author: Li Ya-zi, li.yazi@imicams.ac.cn

DOI: 10.12201/bmr.202108.00003

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  Abstract: In the context of the normalization of population flow and the imbalance of medical resources, the need for immediate reimbursement from basic medical insurance for inter-provincial healthcare is more and more urgent. Relevant departments and governments at all levels have continuously improved the immediate reimbursement service of basic medical insurance, and achieved positive results. Informationization, as a business link connecting inter-provincial long-distance medical institutions, handling institutions and insured persons, has played an important role in promoting normal inter-provincial medical order, improving reimbursement efficiency and strengthening fund supervision. This paper divides the process of cross-provincial direct immediate reimbursement information construction into 3 stages as inter-provincial point-to-point exploration information (from 2014 to 2016), the platform information construction period (from 2016 to 2018) with the national direct settlement system, and on national healthcare insurance information platform as the core of the integration of service information promotion period (after 2018). The content and characteristics of these stages of construction were analyzed, and its construction effect was summarized. Combined with the current situation, we concluded the prospection of informationization for immediate reimbursement for inter-provincial healthcare, in order to provide reference for the information construction.

  Key words: inter-provincia healthcare, immediate reimbursement, informationization, basic medical insurance

  Submit time: 31 August 2021

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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