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Study on Improving Hospital Compensation in County-level and Above of New Rural Cooperative Medical System

Author: YangRuiZuo
Tutor: ChenYingChun
School: Huazhong University of Science and Technology
Course: Social Medicine and Health Management
Keywords: The new type of rural cooperative medical care Hospitalization costs Level of compensation
CLC: R197.1
Type: Master's thesis
Year: 2011
Downloads: 23
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Abstract

Objective: This study summarizes the eight counties and cities in Hubei Province NRCMS County and more than patient compensation levels, analysis of the factors that affect the actual compensation ratio, to explore an appropriate increase in the County, and inpatient medical institutions above the actual compensation ratio strategy to Farmer Participation continuously improve the level of protection, and to promote the new rural cooperative goals and sustainable development. Methods: Using a combination of quantitative research and qualitative research methods to analyze. The main methods include: (1) documentary research: the use of tools such as network, books, periodicals, systematic literature search was performed and data query to a comprehensive understanding of the domestic and foreign health insurance compensation program design theory and methodology and research; (2 the) Scene Investigation: analysis through questionnaires, interviews and other methods of sampling the new rural cooperative medical compensation program design, hospital compensation status quo; (3) statistical analysis methods: the use of descriptive analysis method to analyze the survey area and above county agencies level of hospital costs the status of the actual level of compensation; (4) theoretical analysis method: the use of Management, Health Management, health economics theories, combined with research and analysis of the results of the analysis of the national or local policy, proposed an appropriate increase in the county and the above institutions hospitalized actual compensation ratio policy recommendations. Results: (1) County and the lower level of the medical institutions above the compensation ratio, seriously affecting the overall level of compensation of the new rural cooperative. Actual compensation of township medical institutions has reached a high level, you want to continue to enhance the township level hospital by the name of compensation there are greater difficulties than to raise the overall level of compensation. (2) the cost of hospitalization and hospitalization rates continue to rise, there is a weak link in the management of designated medical institutions. With the continuous development of the socio-economic and medical needs of the farmers continue to improve, hospitalization rates increased faster in some places even up to 10% or more, while medical costs are also rising, exacerbated the pressure on the new rural cooperative medical fund. (3) referral mechanism is not perfect, patient flow unreasonable. The one hand, the growth in the income level of farmers, continuously improve the health-conscious, want to get a higher level of medical service, on the other hand, the two-way referral system is not perfect, the farmers easy to turn on the next turn hard, on the current situation, this simple rely on the ratio of compensation, since the gap between economic factors went on the line design flows to guide farmers whose role is extremely limited. (4) a lower proportion of major diseases compensation, affect the overall level of compensation. Disease complex of major diseases, the majority of patients treated in the county and more medical institutions, agencies above the county level the nominal compensation ratio unified set lower, while the per capita cost of hospitalization for major diseases is high, this way, so that a lower proportion of the actual compensation not only a heavy financial burden to the family, but also affect the overall level of compensation. (5) accidental injury patients complicated reasons, the compensation ratio is low, affecting the overall level of compensation. Most parts of accidental injury to the patient to take up a lot of new rural cooperative funds, while around the lack of uniform standards for the determination of accidental injury, not set reasonable compensation ratio, resulting in lower levels of compensation. Recommended (1) according to local conditions, the optimization of the compensation package. Around the premise of ensuring the safety of the new rural cooperative fund, a moderate expansion of the scope of compensation, set a reasonable pay line, and improve the overall level of compensation. (2) strictly regulate the way referral system, and actively explore the implementation of the first diagnosis system, the rational allocation of medical resources, investment in the hardware and software of the primary health care sector to guide the rational flow of patients. (3) actively carry out pilot work to improve the security level of the major diseases in rural areas, to explore the accidental injury screening standards, and improve the overall level of compensation. (4) active in the payment reform, increase supervision at all levels of the new rural cooperative medical institutions, to control the unreasonable growth of medical costs.

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