Hebei Province's full implementation of day surgery can be included in medical insurance hospitalization expenses settlement

A few days ago, on the basis of summing up the preliminary experience, the Hebei Provincial Health and Health Commission and the Provincial Medical Security Bureau decided to perform day -day surgery in the province's medical institutions.

Daily surgery refers to surgery or operations completed and discharged in accordance with the diagnosis and treatment plan in accordance with the diagnosis and treatment plan, excluding outpatient surgery or examination. Special cases of delaying hospitalization due to the need to be postponed, and the hospitalization time does not exceed 48 hours.

What kind of hospital can perform daytime surgery? Our province states that the second or above medical institutions that meet the following conditions. A diagnosis and treatment subjects approved by the health and health administrative department are consistent with surgery. Set up an independent day surgery center or day operating room, or reserve a fixed surgery room for the implementation of the day surgery in the existing operating room. Related surgical centers or operating rooms meet the "Hospital Surgery Department (Room) Management Specification (Trial)". With regular training and completing the clinical application ability of the corresponding surgery operation, the registered physician and other necessary technical personnel of the hospital. There are at least 1 to 2 full -time personnel responsible for the unified management of patients with day surgery. At the same time, it sets up auxiliary departments such as anesthesiology, intensive care rooms such as day surgery, and is equipped with necessary professional and technical personnel and facilities.

In terms of the implementation of diseases, the Provincial Health and Health Commission has formulated the "Recommended Catalog of Dynasties of Hebei Province (2022 Edition)". In order to strengthen the management of day surgery, our province requires that if the patient needs to perform daytime surgery after diagnosis, the medical institution and the patient signed a day surgery consent form to go through the day -to -day surgery registration procedures, and within 1 week For treatment and pre -hospital examination and evaluation before hospitalization, the relevant situation should be clearly recorded in the daily surgery medical records.

In terms of medical insurance payment, our province clearly states that the expenses of the insured personnel during the day are in line with the scope of the medical insurance policy. Daily surgery costs include medical expenses during the hospitalization period in accordance with the diagnosis and treatment plan and the compliance outpatient expenses that do not exceed 1 week before and after discharge. After the medical insurance department implements DIP/DRG payment for designated medical institutions, the qualified day surgery costs are uniformly included in DIP/DRG payment management. (Reporter Zhang Shuhui)

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