This article is based on the work practice of Medical-lnsurance-Medicine Linkage carried out by the Nanping First Hospital Affiliated to Fujian Medical University under the reform of payment based on diagnosis related group (DRG). It outlines the connotation and extension of Medical-lnsurance-Medicine Linkage in the hospital, including concept definition, organizational structure, the relationship between DRG payment and Medical-lnsurance-Medicine Linkage, and summarizes the specific measures and positive results of the Medical-lnsurance-Medicine Linkage work mechanism from four aspects: medical quality management, medical insurance management, medical drugs/consumables management, and performance evaluation. These experiences are of great significance for improving the quality and efficiency of medical care, actively responding to the reform of medical insurance payment methods, enhancing the level of medical services in public hospitals, and achieving a win situation among the medical insurance management departments, hospitals, and patients.
Citation： XU Shanghua, DONG Siping, JIANG Ling, HUANG Qilei, LAI Lehan. Exploration of the “Medical-lnsurance-Medicine Linkage” working mechanism in a municipal tertiary hospital under the background of medical insurance payment reform. West China Medical Journal, 2023, 38(12): 1885-1889. doi: 10.7507/1002-0179.202311100 Copy