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  1. 0 資料タイプ別
  2. 03 紀要論文
  1. 250 大学院医歯学総合研究科(医)
  2. 20 紀要
  3. 02 新潟医学会雑誌
  4. 第108巻第4号

5) 審査の現状とあり方(シンポジウム 保険医療をめぐる諸問題, 第489回新潟医学会総会)

http://hdl.handle.net/10191/38178
http://hdl.handle.net/10191/38178
d89a7445-dcbf-4a36-b8db-f2fe7cf218fe
名前 / ファイル ライセンス アクション
108(4)_274-282.pdf 108(4)_274-282.pdf (1.7 MB)
Item type 紀要論文 / Departmental Bulletin Paper(1)
公開日 2016-02-10
タイトル
タイトル 5) 審査の現状とあり方(シンポジウム 保険医療をめぐる諸問題, 第489回新潟医学会総会)
タイトル
言語 en
タイトル 5) 審査の現状とあり方(シンポジウム 保険医療をめぐる諸問題, 第489回新潟医学会総会)
言語
言語 jpn
キーワード
主題Scheme Other
主題 review of medical insurance claims
キーワード
主題Scheme Other
主題 arbitrary agreements against science
キーワード
主題Scheme Other
主題 保険医療の審査
キーワード
主題Scheme Other
主題 学問と約束事
資源タイプ
資源 http://purl.org/coar/resource_type/c_6501
タイプ departmental bulletin paper
その他のタイトル
その他のタイトル The Present State and Goal of Reviewing Medical Insurance Claims (Problems in Medical Care based on the health Insurance System)
著者 小池, 昭彦

× 小池, 昭彦

WEKO 120725

小池, 昭彦

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著者別名
識別子 120726
識別子Scheme WEKO
姓名 Koike, Akihiko
抄録
内容記述タイプ Abstract
内容記述 Medical insurance institution in Japan is running based on the system with payment at piece rates. It has been disclosed that this system has both advantages and disadvantages, and on its practical applications reviewing commitees are assigned to deal with details. On submission of insurance claims, they are inspected for their documental formalities and then documented medical practices are examined for their suitability in a course of primary assesment. Some claims are reduced or returned for improvement of documentation in the process of assessment. In Niigata prefecture, the rate of return is the highest in Japan and the incidence of reduction is low, which probably reflects our efforts to avoid economical losses for medical institutes by returning and letting incomplete claims be improved. In addition to this, there are an increasing number of requests for re-assessment made by insurers after the completion of primary assessment, which is one of the biggest problems in the current system. Most problems in the current system of insurance assessment come from the fact that the current medical insurance institution is not based on theoretical background but is constructed on arbitrary agreements. It is, therfore, the most important issue for the commitee to reduce inconsistency in the current system and rebuild it in a more scientific manner.
書誌情報 新潟医学会雑誌
en : 新潟医学会雑誌

巻 108, 号 4, p. 274-282, 発行日 1994-04
出版者
出版者 新潟医学会
ISSN
収録物識別子タイプ ISSN
収録物識別子 00290440
書誌レコードID
収録物識別子タイプ NCID
収録物識別子 AN00182415
著者版フラグ
値 publisher
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